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Cameron D, Soto-Mota A, Willis DR, Ellis J, Procter NEK, Greenwood R, Saunders N, Schulte RF, Vassiliou VS, Tyler DJ, Schmid AI, Rodgers CT, Malcolm PN, Clarke K, Frenneaux MP, Valkovič L. Evaluation of Acute Supplementation With the Ketone Ester (R)-3-Hydroxybutyl-(R)-3-Hydroxybutyrate (deltaG) in Healthy Volunteers by Cardiac and Skeletal Muscle 31P Magnetic Resonance Spectroscopy. Front Physiol 2022; 13:793987. [PMID: 35173629 PMCID: PMC8841822 DOI: 10.3389/fphys.2022.793987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/05/2022] [Indexed: 01/11/2023] Open
Abstract
In this acute intervention study, we investigated the potential benefit of ketone supplementation in humans by studying cardiac phosphocreatine to adenosine-triphosphate ratios (PCr/ATP) and skeletal muscle PCr recovery using phosphorus magnetic resonance spectroscopy (31P-MRS) before and after ingestion of a ketone ester drink. We recruited 28 healthy individuals: 12 aged 23–70 years for cardiac 31P-MRS, and 16 aged 60–75 years for skeletal muscle 31P-MRS. Baseline and post-intervention resting cardiac and dynamic skeletal muscle 31P-MRS scans were performed in one visit, where 25 g of the ketone monoester, deltaG®, was administered after the baseline scan. Administration was timed so that post-intervention 31P-MRS would take place 30 min after deltaG® ingestion. The deltaG® ketone drink was well-tolerated by all participants. In participants who provided blood samples, post-intervention blood glucose, lactate and non-esterified fatty acid concentrations decreased significantly (−28.8%, p ≪ 0.001; −28.2%, p = 0.02; and −49.1%, p ≪ 0.001, respectively), while levels of the ketone body D-beta-hydroxybutyrate significantly increased from mean (standard deviation) 0.7 (0.3) to 4.0 (1.1) mmol/L after 30 min (p ≪ 0.001). There were no significant changes in cardiac PCr/ATP or skeletal muscle metabolic parameters between baseline and post-intervention. Acute ketone supplementation caused mild ketosis in blood, with drops in glucose, lactate, and free fatty acids; however, such changes were not associated with changes in 31P-MRS measures in the heart or in skeletal muscle. Future work may focus on the effect of longer-term ketone supplementation on tissue energetics in groups with compromised mitochondrial function.
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Affiliation(s)
- Donnie Cameron
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Department of Radiology, C.J. Gorter Center for High-Field MRI, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Donnie Cameron,
| | - Adrian Soto-Mota
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - David R. Willis
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Jane Ellis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | | | - Richard Greenwood
- Radiology Department, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Neil Saunders
- Radiology Department, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | | | | | - Damian J. Tyler
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
| | - Albrecht Ingo Schmid
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Christopher T. Rodgers
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom
| | - Paul N. Malcolm
- Radiology Department, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Kieran Clarke
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | | | - Ladislav Valkovič
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
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2
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Krumpolec P, Klepochová R, Just I, Tušek Jelenc M, Frollo I, Ukropec J, Ukropcová B, Trattnig S, Krššák M, Valkovič L. Multinuclear MRS at 7T Uncovers Exercise Driven Differences in Skeletal Muscle Energy Metabolism Between Young and Seniors. Front Physiol 2020; 11:644. [PMID: 32695010 PMCID: PMC7336536 DOI: 10.3389/fphys.2020.00644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/20/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose: Aging is associated with changes in muscle energy metabolism. Proton (1H) and phosphorous (31P) magnetic resonance spectroscopy (MRS) has been successfully applied for non-invasive investigation of skeletal muscle metabolism. The aim of this study was to detect differences in adenosine triphosphate (ATP) production in the aging muscle by 31P-MRS and to identify potential changes associated with buffer capacity of muscle carnosine by 1H-MRS. Methods: Fifteen young and nineteen elderly volunteers were examined. 1H and 31P-MRS spectra were acquired at high field (7T). The investigation included carnosine quantification using 1H-MRS and resting and dynamic 31P-MRS, both including saturation transfer measurements of phosphocreatine (PCr), and inorganic phosphate (Pi)-to-ATP metabolic fluxes. Results: Elderly volunteers had higher time constant of PCr recovery (τPCr) in comparison to the young volunteers. Exercise was connected with significant decrease in PCr-to-ATP flux in both groups. Moreover, PCr-to-ATP flux was significantly higher in young compared to elderly both at rest and during exercise. Similarly, an increment of Pi-to-ATP flux with exercise was found in both groups but the intergroup difference was only observed during exercise. Elderly had lower muscle carnosine concentration and lower postexercise pH. A strong increase in phosphomonoester (PME) concentration was observed with exercise in elderly, and a faster Pi:PCr kinetics was found in young volunteers compared to elderly during the recovery period. Conclusion: Observations of a massive increment of PME concentration together with high Pi-to-ATP flux during exercise in seniors refer to decreased ability of the muscle to meet the metabolic requirements of exercise and thus a limited ability of seniors to effectively support the exercise load.
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Affiliation(s)
- Patrik Krumpolec
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Radka Klepochová
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ivica Just
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Marjeta Tušek Jelenc
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ivan Frollo
- Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Jozef Ukropec
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Barbara Ukropcová
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia.,Faculty of Medicine, Institute of Pathophysiology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Martin Krššák
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.,Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Ladislav Valkovič
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia.,Oxford Centre for Clinical Magnetic Resonance Research, RDM Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
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3
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Meyerspeer M, Boesch C, Cameron D, Dezortová M, Forbes SC, Heerschap A, Jeneson JA, Kan HE, Kent J, Layec G, Prompers JJ, Reyngoudt H, Sleigh A, Valkovič L, Kemp GJ. 31 P magnetic resonance spectroscopy in skeletal muscle: Experts' consensus recommendations. NMR IN BIOMEDICINE 2020; 34:e4246. [PMID: 32037688 PMCID: PMC8243949 DOI: 10.1002/nbm.4246] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 05/07/2023]
Abstract
Skeletal muscle phosphorus-31 31 P MRS is the oldest MRS methodology to be applied to in vivo metabolic research. The technical requirements of 31 P MRS in skeletal muscle depend on the research question, and to assess those questions requires understanding both the relevant muscle physiology, and how 31 P MRS methods can probe it. Here we consider basic signal-acquisition parameters related to radio frequency excitation, TR, TE, spectral resolution, shim and localisation. We make specific recommendations for studies of resting and exercising muscle, including magnetisation transfer, and for data processing. We summarise the metabolic information that can be quantitatively assessed with 31 P MRS, either measured directly or derived by calculations that depend on particular metabolic models, and we give advice on potential problems of interpretation. We give expected values and tolerable ranges for some measured quantities, and minimum requirements for reporting acquisition parameters and experimental results in publications. Reliable examination depends on a reproducible setup, standardised preconditioning of the subject, and careful control of potential difficulties, and we summarise some important considerations and potential confounders. Our recommendations include the quantification and standardisation of contraction intensity, and how best to account for heterogeneous muscle recruitment. We highlight some pitfalls in the assessment of mitochondrial function by analysis of phosphocreatine (PCr) recovery kinetics. Finally, we outline how complementary techniques (near-infrared spectroscopy, arterial spin labelling, BOLD and various other MRI and 1 H MRS measurements) can help in the physiological/metabolic interpretation of 31 P MRS studies by providing information about blood flow and oxygen delivery/utilisation. Our recommendations will assist in achieving the fullest possible reliable picture of muscle physiology and pathophysiology.
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Affiliation(s)
- Martin Meyerspeer
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
- High Field MR CenterMedical University of ViennaViennaAustria
| | - Chris Boesch
- DBMR and DIPRUniversity and InselspitalBernSwitzerland
| | - Donnie Cameron
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
| | - Monika Dezortová
- MR‐Unit, Department of Diagnostic and Interventional RadiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Sean C. Forbes
- Department of Physical TherapyUniversity of FloridaGainesvilleFloridaUSA
| | - Arend Heerschap
- Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | - Jeroen A.L. Jeneson
- Department of RadiologyAmsterdam University Medical Center|site AMCAmsterdamthe Netherlands
- Cognitive Neuroscience CenterUniversity Medical Center GroningenGroningenthe Netherlands
- Center for Child Development and Exercise, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Hermien E. Kan
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CentreLeidenthe Netherlands
- Duchenne CenterThe Netherlands
| | - Jane Kent
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
| | - Gwenaël Layec
- Department of KinesiologyUniversity of Massachusetts AmherstMAUSA
- Institute for Applied Life SciencesUniversity of MassachusettsAmherstMAUSA
| | | | - Harmen Reyngoudt
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of Myology AIM‐CEAParisFrance
| | - Alison Sleigh
- Wolfson Brain Imaging CentreUniversity of CambridgeCambridgeUK
- Wellcome Trust‐MRC Institute of Metabolic ScienceUniversity of CambridgeCambridgeUK
- NIHR/Wellcome Trust Clinical Research FacilityCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Ladislav Valkovič
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR), RDM Cardiovascular Medicine, BHF Centre of Research ExcellenceUniversity of OxfordOxfordUK
- Department of Imaging MethodsInstitute of Measurement Science, Slovak Academy of SciencesBratislavaSlovakia
| | - Graham J. Kemp
- Department of Musculoskeletal Biology and Liverpool Magnetic Resonance Imaging Centre (LiMRIC)University of LiverpoolLiverpoolUK
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Ren J, Sherry AD, Malloy CR. Modular 31 P wideband inversion transfer for integrative analysis of adenosine triphosphate metabolism, T 1 relaxation and molecular dynamics in skeletal muscle at 7T. Magn Reson Med 2019; 81:3440-3452. [PMID: 30793793 DOI: 10.1002/mrm.27686] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE For efficient and integrative analysis of de novo adenosine triphosphate (ATP) synthesis, creatine-kinase-mediated ATP synthesis, T1 relaxation time, and ATP molecular motion dynamics in human skeletal muscle at rest. METHODS Four inversion-transfer modules differing in center inversion frequency were combined to generate amplified magnetization transfer (MT) effects in targeted MT pathways, including Pi ↔ γ-ATP, PCr ↔ γ-ATP, and 31 Pγ(α)ATP ↔ 31 PβATP . MT effects from both forward and reverse exchange kinetic pathways were acquired to reduce potential bias and confounding factors in integrated data analysis. RESULTS Kinetic data collected using 4 wideband inversion modules (8 minutes each) yielded the forward exchange rate constants, kPCr →γ ATP = 0.31 ± 0.05 s-1 and kPi →γ ATP = 0.064 ± 0.012 s-1 , and the reverse exchange rate constants, kγATP→Pi = 0.034 ± 0.006 s-1 and kγATP→PCr = 1.37 ± 0.22 s-1 , respectively. The cross-relaxation rate constant, σγ(α) ↔ βATP was -0.20 ± 0.03 s-1 , corresponding to ATP rotational correlation time τc of 0.8 ± 0.1 × 10-7 seconds. The intrinsic T1 relaxation times were Pi (9.2 ± 1.4 seconds), PCr (6.2 ± 0.4 seconds), γ-ATP (1.8 ± 0.1 seconds), α-ATP (1.4 ± 0.1 seconds), and β-ATP (1.1 ± 0.1 seconds). Muscle ATP T1 values were found to be significantly longer than those previously measured in the brain using a similar method. CONCLUSION A combination of multiple inversion transfer modules provides a comprehensive and integrated analysis of ATP metabolism and molecular motion dynamics. This relatively fast technique could be potentially useful for studying metabolic disorders in skeletal muscle.
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Affiliation(s)
- Jimin Ren
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - A Dean Sherry
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Chemistry, University of Texas at Dallas, Richardson, Texas
| | - Craig R Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,VA North Texas Health Care System, Dallas, Texas
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5
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Du F, Yuksel C, Chouinard VA, Huynh P, Pingali S, Ryan K, Cohen BM, Öngür D. Abnormalities in High-Energy Phosphate Metabolism in First-Episode Bipolar Disorder Measured Using 31P-Magnetic Resonance Spectroscopy. Biol Psychiatry 2018; 84:797-802. [PMID: 28527566 PMCID: PMC5632123 DOI: 10.1016/j.biopsych.2017.03.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Brain energy metabolism is critical for supporting synaptic function and information processing. A growing body of evidence suggests abnormalities in brain bioenergetics in psychiatric disorders, including both bipolar disorder (BD) and schizophrenia. 31P magnetic resonance spectroscopy provides a noninvasive window into these processes in vivo. Using this approach, we previously showed that patients with BD show normal adenosine triphosphate (ATP) and phosphocreatine levels at rest but cannot maintain normal ATP levels in the visual cortex during times of high energy demand (photic stimulation). Because ATP is replenished from phosphocreatine via the creatine kinase reaction, we have now measured the creatine kinase forward reaction rate constant in BD. METHODS We studied 20 patients experiencing a first episode of BD and 28 healthy control participants at 4T and quantified creatine kinase forward reaction rate constant using 31P magnetization transfer magnetic resonance spectroscopy as described previously. RESULTS We found a significant reduction in creatine kinase forward reaction rate constant in the BD group (F = 4.692, p = .036), whereas brain ATP and phosphocreatine concentrations, as well as brain parenchymal pH, were normal. CONCLUSIONS These results pinpoint a specific molecular mechanism underlying our previous observation of an inability to replenish brain ATP during times of high energy demand in BD.
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Affiliation(s)
- Fei Du
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | - Cagri Yuksel
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | | | | | | | | | - Bruce M. Cohen
- McLean Hospital, Belmont, MA,Harvard Medical School, Boston, MA
| | - Dost Öngür
- McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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6
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Klepochová R, Valkovič L, Hochwartner T, Triska C, Bachl N, Tschan H, Trattnig S, Krebs M, Krššák M. Differences in Muscle Metabolism Between Triathletes and Normally Active Volunteers Investigated Using Multinuclear Magnetic Resonance Spectroscopy at 7T. Front Physiol 2018; 9:300. [PMID: 29666584 PMCID: PMC5891578 DOI: 10.3389/fphys.2018.00300] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/13/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose: The influence of endurance training on skeletal muscle metabolism can currently be studied only by invasive sampling or through a few related parameters that are investigated by either proton (1H) or phosphorus (31P) magnetic resonance spectroscopy (MRS). The aim of this study was to compare the metabolic differences between endurance-trained triathletes and healthy volunteers using multi-parametric data acquired by both, 31P- and 1H-MRS, at ultra-high field (7T) in a single experimental protocol. This study also aimed to determine the interrelations between these MRS-derived metabolic parameters. Methods: Thirteen male triathletes and ten active male volunteers participated in the study. Proton MRS data from the vastus lateralis yielded concentrations of acetylcarnitine, carnosine, and intramyocellular lipids (IMCL). For the measurement of phosphodiesters (PDEs), inorganic phosphate (Pi), phosphocreatine (PCr), and maximal oxidative capacity (Qmax) phosphorus MRS data were acquired at rest, during 6 min of submaximal exercise and following immediate recovery. Results: The triathletes exhibited significantly higher IMCL levels, higher initial rate of PCr resynthesis (VPCr) during the recovery period, a shorter PCr recovery time constant (τPCr), and higher Qmax. Multivariate stepwise regression analysis identified PDE as the strongest independent predictor of whole-body maximal oxygen uptake (VO2max). Conclusion: In conclusion, we cannot suggest a single MRS-based parameter as an exclusive biomarker of muscular fitness and training status. There is, rather, a combination of different parameters, assessable during a single multi-nuclear MRS session that could be useful for further cross-sectional and/or focused interventional studies on skeletal muscle fitness and training effects.
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Affiliation(s)
- Radka Klepochová
- Department of Biomedical Imaging and Image-Guided Therapy, High-Field MR Center, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, MOLIMA, Vienna, Austria
| | - Ladislav Valkovič
- Oxford Centre for Clinical Magnetic Resonance Research, BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Thomas Hochwartner
- Centre of Sport Science and University Sport, University of Vienna, Vienna, Austria
| | - Christoph Triska
- Centre of Sport Science and University Sport, University of Vienna, Vienna, Austria
| | - Norbert Bachl
- Centre of Sport Science and University Sport, University of Vienna, Vienna, Austria
| | - Harald Tschan
- Centre of Sport Science and University Sport, University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- Department of Biomedical Imaging and Image-Guided Therapy, High-Field MR Center, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, MOLIMA, Vienna, Austria
| | - Michael Krebs
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Martin Krššák
- Department of Biomedical Imaging and Image-Guided Therapy, High-Field MR Center, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, MOLIMA, Vienna, Austria.,Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Abstract
Objectives The aims of this study were to detect the acetylcarnitine resonance line at 2.13 ppm in the human vastus lateralis and soleus muscles, assess T1 and T2 relaxation times, and investigate the diurnal and exercise-related changes in absolute concentration noninvasively, using proton magnetic resonance spectroscopy at 7 T. Materials and Methods All measurements were performed on a 7 T whole-body Magnetom MR system with a 28-channel knee coil. Five healthy, moderately trained volunteers participated in the assessment of the detectability, repeatability, and relaxation times of acetylcarnitine. For the evaluation of the effect of training status, another 5 healthy, normally active volunteers were examined. In addition, normally active volunteers underwent a day-long protocol to estimate diurnal changes and response to the exercise. Results Using a long echo time of 350 milliseconds, we were able to detect the acetylcarnitine resonance line at 2.13 ppm in both muscle groups without significant lipid contamination. The T1 of acetylcarnitine in the vastus lateralis muscle was found to be 1807.2 ± 513.1 milliseconds and T2 was found to be 129.9 ± 44.9 milliseconds. Concentrations of acetylcarnitine from the vastus lateralis muscle in moderately trained volunteers were higher than concentrations from normally active volunteers. Acetylcarnitine concentrations changed during the day, tending to be higher in the morning after an overnight fast than after lunch. After 10 minutes of high-intensity exercise, the concentration significantly increased, and 15 minutes after cessation of exercise, a decrease could be observed. Conclusions Our results demonstrate an effective detection of acetylcarnitine using a long TE of 350 milliseconds at 7 T in the vastus lateralis and soleus muscles with high repeatability and reliability on a 7 T scanner. Our data emphasize the need for strict standardization, physical activity, and dietary conditions for the measurement of the acetylcarnitine.
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Liu Y, Gu Y, Yu X. Assessing tissue metabolism by phosphorous-31 magnetic resonance spectroscopy and imaging: a methodology review. Quant Imaging Med Surg 2017; 7:707-726. [PMID: 29312876 PMCID: PMC5756783 DOI: 10.21037/qims.2017.11.03] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/11/2017] [Indexed: 01/11/2023]
Abstract
Many human diseases are caused by an imbalance between energy production and demand. Magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) provide the unique opportunity for in vivo assessment of several fundamental events in tissue metabolism without the use of ionizing radiation. Of particular interest, phosphate metabolites that are involved in ATP generation and utilization can be quantified noninvasively by phosphorous-31 (31P) MRS/MRI. Furthermore, 31P magnetization transfer (MT) techniques allow in vivo measurement of metabolic fluxes via creatine kinase (CK) and ATP synthase. However, a major impediment for the clinical applications of 31P-MRS/MRI is the prohibitively long acquisition time and/or the low spatial resolution that are necessary to achieve adequate signal-to-noise ratio. In this review, current 31P-MRS/MRI techniques used in basic science and clinical research are presented. Recent advances in the development of fast 31P-MRS/MRI methods are also discussed.
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Affiliation(s)
- Yuchi Liu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Yuning Gu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Xin Yu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH, USA
- Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH, USA
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9
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Hooijmans MT, Doorenweerd N, Baligand C, Verschuuren JJGM, Ronen I, Niks EH, Webb AG, Kan HE. Spatially localized phosphorous metabolism of skeletal muscle in Duchenne muscular dystrophy patients: 24-month follow-up. PLoS One 2017; 12:e0182086. [PMID: 28763477 PMCID: PMC5538641 DOI: 10.1371/journal.pone.0182086] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/12/2017] [Indexed: 12/29/2022] Open
Abstract
Objectives To assess the changes in phosphodiester (PDE)-levels, detected by 31P magnetic resonance spectroscopy (MRS), over 24-months to determine the potential of PDE as marker for muscle tissue changes in Duchenne Muscular Dystrophy (DMD) patients. Methods Spatially resolved phosphorous datasets were acquired in the right lower leg of 18 DMD patients (range: 5–15.4 years) and 12 age-matched healthy controls (range: 5–14 years) at three time-points (baseline, 12-months, and 24-months) using a 7T MR-System (Philips Achieva). 3-point Dixon images were acquired at 3T (Philips Ingenia) to determine muscle fat fraction. Analyses were done for six muscles that represent different stages of muscle wasting. Differences between groups and time-points were assessed with non-parametric tests with correction for multiple comparisons. Coefficient of variance (CV) were determined for PDE in four healthy adult volunteers in high and low signal-to-noise ratio (SNR) datasets. Results PDE-levels were significantly higher (two-fold) in DMD patients compared to controls in all analyzed muscles at almost every time point and did not change over the study period. Fat fraction was significantly elevated in all muscles at all time points compared to healthy controls, and increased significantly over time, except in the tibialis posterior muscle. The mean within subject CV for PDE-levels was 4.3% in datasets with high SNR (>10:1) and 5.7% in datasets with low SNR. Discussion and conclusion The stable two-fold increase in PDE-levels found in DMD patients in muscles with different levels of muscle wasting over 2-year time, including DMD patients as young as 5.5 years-old, suggests that PDE-levels may increase very rapidly early in the disease process and remain elevated thereafter. The low CV values in high and low SNR datasets show that PDE-levels can be accurately and reproducibly quantified in all conditions. Our data confirms the great potential of PDE as a marker for muscle tissue changes in DMD patients.
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Affiliation(s)
- M. T. Hooijmans
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - N. Doorenweerd
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
- John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - C. Baligand
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | | | - I. Ronen
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - E. H. Niks
- Dept of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - A. G. Webb
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - H. E. Kan
- Dept of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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Valkovič L, Chmelík M, Krššák M. In-vivo 31P-MRS of skeletal muscle and liver: A way for non-invasive assessment of their metabolism. Anal Biochem 2017; 529:193-215. [PMID: 28119063 PMCID: PMC5478074 DOI: 10.1016/j.ab.2017.01.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 01/13/2017] [Accepted: 01/19/2017] [Indexed: 01/18/2023]
Abstract
In addition to direct assessment of high energy phosphorus containing metabolite content within tissues, phosphorus magnetic resonance spectroscopy (31P-MRS) provides options to measure phospholipid metabolites and cellular pH, as well as the kinetics of chemical reactions of energy metabolism in vivo. Even though the great potential of 31P-MR was recognized over 30 years ago, modern MR systems, as well as new, dedicated hardware and measurement techniques provide further opportunities for research of human biochemistry. This paper presents a methodological overview of the 31P-MR techniques that can be used for basic, physiological, or clinical research of human skeletal muscle and liver in vivo. Practical issues of 31P-MRS experiments and examples of potential applications are also provided. As signal localization is essential for liver 31P-MRS and is important for dynamic muscle examinations as well, typical localization strategies for 31P-MR are also described.
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Affiliation(s)
- Ladislav Valkovič
- High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, Oxford, United Kingdom; Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia.
| | - Marek Chmelík
- High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria; Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria
| | - Martin Krššák
- High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria; Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Valkovič L, Chmelík M, Meyerspeer M, Gagoski B, Rodgers CT, Krššák M, Andronesi OC, Trattnig S, Bogner W. Dynamic 31 P-MRSI using spiral spectroscopic imaging can map mitochondrial capacity in muscles of the human calf during plantar flexion exercise at 7 T. NMR IN BIOMEDICINE 2016; 29:1825-1834. [PMID: 27862510 PMCID: PMC5132121 DOI: 10.1002/nbm.3662] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/19/2016] [Accepted: 09/28/2016] [Indexed: 05/06/2023]
Abstract
Phosphorus MRSI (31 P-MRSI) using a spiral-trajectory readout at 7 T was developed for high temporal resolution mapping of the mitochondrial capacity of exercising human skeletal muscle. The sensitivity and localization accuracy of the method was investigated in phantoms. In vivo performance was assessed in 12 volunteers, who performed a plantar flexion exercise inside a whole-body 7 T MR scanner using an MR-compatible ergometer and a surface coil. In five volunteers the knee was flexed (~60°) to shift the major workload from the gastrocnemii to the soleus muscle. Spiral-encoded MRSI provided 16-25 times faster mapping with a better point spread function than elliptical phase-encoded MRSI with the same matrix size. The inevitable trade-off for the increased temporal resolution was a reduced signal-to-noise ratio, but this was acceptable. The phosphocreatine (PCr) depletion caused by exercise at 0° knee angulation was significantly higher in both gastrocnemii than in the soleus (i.e. 64.8 ± 19.6% and 65.9 ± 23.6% in gastrocnemius lateralis and medialis versus 15.3 ± 8.4% in the soleus). Spiral-encoded 31 P-MRSI is a powerful tool for dynamic mapping of exercising muscle oxidative metabolism, including localized assessment of PCr concentrations, pH and maximal oxidative flux with high temporal and spatial resolution.
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Affiliation(s)
- Ladislav Valkovič
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
- Department of Imaging Methods, Institute of Measurement ScienceSlovak Academy of SciencesBratislavaSlovakia
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR)University of OxfordOxfordUK
| | - Marek Chmelík
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
| | - Martin Meyerspeer
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science CenterBoston Children's HospitalBostonMassachusettsUSA
| | - Christopher T. Rodgers
- Oxford Centre for Clinical Magnetic Resonance Research (OCMR)University of OxfordOxfordUK
| | - Martin Krššák
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
- Division of Endocrinology and Metabolism, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Ovidiu C. Andronesi
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Siegfried Trattnig
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
| | - Wolfgang Bogner
- High‐Field MR CentreMedical University of ViennaViennaAustria
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
- Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
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