{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:12:31Z","timestamp":1790881951187,"version":"4.1.0"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,5]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> This study was conducted to determine whether proton magnetic resonance spectroscopy (MRS) is a sensitive method for detecting diffuse axonal injury, which is a primary sequela of traumatic brain injury (TBI). Diffuse axonal injury is characterized by selective damage to white matter tracts that is caused in part by the severe inertial strain created by rotational acceleration and deceleration, which is often associated with motor vehicle accidents. This axonal injury is typically difficult to detect by using conventional imaging techniques because it is microscopic in nature. The splenium was selected because it is a site vulnerable to shearing forces that produce diffuse axonal injury.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors used proton MRS to evaluate the splenium, the posterior commissure of the corpus callosum, in normal control volunteers and in patients with TBI. Proton MRS provided an index of neuronal and axonal viability by measuring levels of N-acetyl aspartate (NAA).<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> A majority of mildly brain injured patients, as well as those more severely injured, showed diminished NAA\/creatine (Cr) levels in the splenium compared with normal control volunteers. The patients displaying lowered NAA\/Cr in the splenium were also likely to exhibit lowered NAA\/Cr in lobar white matter. Also, the levels of NAA\/Cr in the splenium of normal volunteers were higher compared with those found in lobar white matter. Decreases in NAA\/Cr levels in the splenium may be a marker for diffuse injury. A proton MRS examination may be particularly useful in evaluating mildly injured patients with unexplained neurological and cognitive deficits. It is concluded that MRS is a sensitive tool in detecting axonal injury.<\/jats:p>","DOI":"10.3171\/jns.1998.88.5.0795","type":"journal-article","created":{"date-parts":[[2009,6,16]],"date-time":"2009-06-16T02:13:55Z","timestamp":1245118435000},"page":"795-801","source":"Crossref","is-referenced-by-count":168,"title":["Proton magnetic resonance spectroscopy for detection of axonal injury in the splenium of the corpus callosum of brain-injured patients"],"prefix":"10.3171","volume":"88","author":[{"given":"Kim M.","family":"Cecil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everett C.","family":"Hills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Elizabeth","family":"Sandel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas H.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy K.","family":"McIntosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois J.","family":"Mannon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant P.","family":"Sinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J.","family":"Bagley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert I.","family":"Grossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Lenkinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1989.tb03040.x"},{"key":"b2","first-page":"165","volume-title":"Recent Advances in Neuropathology.","volume":"2","author":"Adams JH","year":"1982"},{"key":"b3","first-page":"65","volume-title":"Central Nervous System Trauma Status Report.","author":"Adams JH","year":"1985"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410120610"},{"key":"b5","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1136\/jcp.33.12.1132","volume":"33","author":"Adams JH","year":"1980","journal-title":"J Clin Pathol"},{"key":"b6","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1093\/brain\/100.3.489","volume":"100","author":"Adams JH","year":"1977","journal-title":"Brain"},{"key":"b7","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1212\/WNL.45.7.1253","volume":"45","author":"Alexander MP","year":"1995","journal-title":"Neurology"},{"key":"b8","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0149-7634(89)80048-X","volume":"13","author":"Birken DL","year":"1989","journal-title":"Neurosci Biobehav Rev"},{"key":"b9","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1159\/000112191","volume":"13","author":"Burri R","year":"1991","journal-title":"Dev Neurosci"},{"key":"b10","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/00004424-199508000-00008","volume":"30","author":"Choe BY","year":"1995","journal-title":"Invest Radiol"},{"key":"b11","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1471-4159.1975.tb07665.x","volume":"24","author":"Clarke DD","year":"1975","journal-title":"J Neurochem"},{"key":"b12","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1111\/j.1471-4159.1973.tb00097.x","volume":"20","author":"D'Adamo AF","year":"1973","journal-title":"J Neurochem"},{"key":"b13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1002\/nbm.1940040408","volume":"4","author":"Frahm J","year":"1991","journal-title":"NMR Biomed"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410120611"},{"key":"b15","first-page":"169","volume-title":"Trauma of the Central Nervous System.","author":"Gennarelli TA","year":"1985"},{"key":"b16","first-page":"611","volume-title":"Magnetic Resonance Imaging of the Brain and Spine","author":"Gentry LR","year":"1996","edition":"2"},{"key":"b17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1148\/radiology.191.1.8134551","volume":"191","author":"Gentry LR","year":"1994","journal-title":"Radiology"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.150.3.663"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.150.3.673"},{"key":"b20","first-page":"1129","volume":"9","author":"Gentry LR","year":"1988","journal-title":"AJNR"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.1995.tb00618.x"},{"key":"b22","doi-asserted-by":"crossref","DOI":"10.4159\/harvard.9780674498266","volume-title":"Living Without Oxygen: Closed and Open Systems in Hypoxia Tolerance.","author":"Hochachka PW","year":"1980"},{"key":"b23","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1111\/j.1471-4159.1984.tb12854.x","volume":"43","author":"Koller KJ","year":"1984","journal-title":"J Neurochem"},{"key":"b24","first-page":"1619","volume-title":"Magnetic Resonance Imaging of the Brain and Spine","author":"Lenkinski RE","year":"1996","edition":"2"},{"key":"b25","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/(SICI)1099-1492(199610)9:7<297::AID-NBM433>3.0.CO;2-4","volume":"9","author":"Lopez-Villegas D","year":"1996","journal-title":"NMR Biomed"},{"key":"b26","first-page":"1583","volume":"15","author":"Mittl RL","year":"1994","journal-title":"AJNR"},{"key":"b27","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1111\/j.1471-4159.1981.tb01665.x","volume":"36","author":"Miyake M","year":"1981","journal-title":"J Neurochem"},{"key":"b28","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/00004728-199505000-00025","volume":"19","author":"Moats RA","year":"1995","journal-title":"J Comput Assist Tomogr"},{"key":"b29","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/00001756-199103000-00005","volume":"2","author":"Moffett JR","year":"1991","journal-title":"Neuroreport"},{"key":"b30","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1042\/bj1570271","volume":"157","author":"Rabinowitz JL","year":"1976","journal-title":"Biochem J"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1492(199610)9:7<279::AID-NBM435>3.0.CO;2-V"},{"key":"b32","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/mrm.1910250110","volume":"25","author":"Rothman DL","year":"1992","journal-title":"Magn Reson Med"},{"key":"b33","doi-asserted-by":"publisher","DOI":"10.1089\/neu.1997.14.441"},{"key":"b34","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF01659936","volume":"1","author":"Seubert W","year":"1973","journal-title":"Mol Cell Biochem"},{"key":"b35","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/00005072-199756070-00009","volume":"56","author":"Smith DH","year":"1997","journal-title":"J Neuropathol Exp Neurol"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)91639-0"},{"key":"b37","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1471-4159.1992.tb08875.x","volume":"59","author":"Urenjak J","year":"1992","journal-title":"J Neurochem"},{"key":"b38","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/mrm.1910310404","volume":"31","author":"Webb PG","year":"1994","journal-title":"Magn Reson Med"},{"key":"b39","doi-asserted-by":"crossref","first-page":"4013","DOI":"10.1016\/S0021-9258(18)95771-6","volume":"242","author":"Whereat AF","year":"1967","journal-title":"J Biol Chem"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/88\/5\/article-p795.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/88\/5\/article-p795.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/88\/5\/article-p795.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T03:49:48Z","timestamp":1653709788000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/88\/5\/article-p795.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,5]]},"references-count":39,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/jns.1998.88.5.0795","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1998,5]]}}}