Investigation of trauma-induced metabolic changes in the thalamus using proton magnetic resonance spectroscopy

Aim This study aimed to noninvasively assess early neurometabolic changes in the thalamic region following trauma in adult individuals, using proton magnetic resonance spectroscopy (¹H-MRS). Methods Adult patients presenting with trauma but without parenchymal damage on computed tomography (CT) were prospectively enrolled. Thalamic MRS evaluations were performed on the 3rd and 15th days post-trauma to measure metabolite levels (N-acetylaspartate [NAA], choline [Cho], creatine [Cr], myo-inositol [mI], lactate [Lac], and glutamate-glutamine [Glx]) and metabolite ratios. Statistical comparisons between the two time points were made using paired t tests, with a significance threshold of P < .05. Results A significant increase in thalamic choline (Cho) levels was detected on the 3rd day after trauma (P < .05). In contrast, no significant changes were observed in NAA, Cr, mI, Lac, Glx levels, or in metabolite ratios (P > .05). Conclusion The findings suggest that early trauma leads to selective metabolic alterations, particularly reflected by increased Cho levels likely associated with early glial activation. Proton MRS may offer a valuable, noninvasive method for detecting early biochemical changes in the central nervous system after trauma, aiding in the early identification of patients at risk for further neurological complications.