1
|
Gudmundson AT, Koo A, Virovka A, Amirault AL, Soo M, Cho JH, Oeltzschner G, Edden RAE, Stark CEL. Meta-analysis and open-source database for in vivo brain Magnetic Resonance spectroscopy in health and disease. Anal Biochem 2023; 676:115227. [PMID: 37423487 PMCID: PMC10561665 DOI: 10.1016/j.ab.2023.115227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/15/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
Proton (1H) Magnetic Resonance Spectroscopy (MRS) is a non-invasive tool capable of quantifying brain metabolite concentrations in vivo. Prioritization of standardization and accessibility in the field has led to the development of universal pulse sequences, methodological consensus recommendations, and the development of open-source analysis software packages. One on-going challenge is methodological validation with ground-truth data. As ground-truths are rarely available for in vivo measurements, data simulations have become an important tool. The diverse literature of metabolite measurements has made it challenging to define ranges to be used within simulations. Especially for the development of deep learning and machine learning algorithms, simulations must be able to produce accurate spectra capturing all the nuances of in vivo data. Therefore, we sought to determine the physiological ranges and relaxation rates of brain metabolites which can be used both in data simulations and as reference estimates. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we've identified relevant MRS research articles and created an open-source database containing methods, results, and other article information as a resource. Using this database, expectation values and ranges for metabolite concentrations and T2 relaxation times are established based upon a meta-analyses of healthy and diseased brains.
Collapse
Affiliation(s)
- Aaron T Gudmundson
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Annie Koo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Anna Virovka
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Alyssa L Amirault
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Madelene Soo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Jocelyn H Cho
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Craig E L Stark
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA.
| |
Collapse
|
2
|
Gudmundson AT, Koo A, Virovka A, Amirault AL, Soo M, Cho JH, Oeltzschner G, Edden RA, Stark C. Meta-analysis and Open-source Database for In Vivo Brain Magnetic Resonance Spectroscopy in Health and Disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.10.528046. [PMID: 37205343 PMCID: PMC10187197 DOI: 10.1101/2023.02.10.528046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Proton ( 1 H) Magnetic Resonance Spectroscopy (MRS) is a non-invasive tool capable of quantifying brain metabolite concentrations in vivo . Prioritization of standardization and accessibility in the field has led to the development of universal pulse sequences, methodological consensus recommendations, and the development of open-source analysis software packages. One on-going challenge is methodological validation with ground-truth data. As ground-truths are rarely available for in vivo measurements, data simulations have become an important tool. The diverse literature of metabolite measurements has made it challenging to define ranges to be used within simulations. Especially for the development of deep learning and machine learning algorithms, simulations must be able to produce accurate spectra capturing all the nuances of in vivo data. Therefore, we sought to determine the physiological ranges and relaxation rates of brain metabolites which can be used both in data simulations and as reference estimates. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we've identified relevant MRS research articles and created an open-source database containing methods, results, and other article information as a resource. Using this database, expectation values and ranges for metabolite concentrations and T 2 relaxation times are established based upon a meta-analyses of healthy and diseased brains.
Collapse
Affiliation(s)
- Aaron T. Gudmundson
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Annie Koo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Anna Virovka
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Alyssa L. Amirault
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Madelene Soo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Jocelyn H. Cho
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Craig Stark
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| |
Collapse
|
3
|
Choline Improves Neonatal Hypoxia-Ischemia Induced Changes in Male but Not Female Rats. Int J Mol Sci 2022; 23:ijms232213983. [PMID: 36430459 PMCID: PMC9694200 DOI: 10.3390/ijms232213983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Choline is an essential nutrient with many roles in brain development and function. Supplementation of choline in early development can have long-lasting benefits. Our experiments aimed to determine the efficacy of choline supplementation in a postnatal day (PND) 10 rat model of neonatal hypoxia ischemia (HI) at term using both male and female rat pups. Choline (100 mg/kg) or saline administration was initiated the day after birth and given daily for 10 or 14 consecutive days. We determined choline's effects on neurite outgrowth of sex-specific cultured cerebellar granule cells after HI with and without choline. The magnitude of tissue loss in the cerebrum was determined at 72 h after HI and in adult rats. The efficacy of choline supplementation in improving motor ability and learning, tested using eyeblink conditioning, were assessed in young adult male and female rats. Overall, we find that choline improves neurite outgrowth, short-term histological measures and learning ability in males. Surprisingly, choline did not benefit females, and appears to exacerbate HI-induced changes.
Collapse
|
4
|
Prognostic MRS in neonatal encephalopathy: closer to generalizability. Pediatr Res 2022; 91:486-487. [PMID: 34728810 PMCID: PMC8916966 DOI: 10.1038/s41390-021-01803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 11/11/2022]
|
5
|
Song Y, Lally PJ, Yanez Lopez M, Oeltzschner G, Nebel MB, Gagoski B, Kecskemeti S, Hui SCN, Zöllner HJ, Shukla D, Arichi T, De Vita E, Yedavalli V, Thayyil S, Fallin D, Dean DC, Grant PE, Wisnowski JL, Edden RAE. Edited magnetic resonance spectroscopy in the neonatal brain. Neuroradiology 2022; 64:217-232. [PMID: 34654960 PMCID: PMC8887832 DOI: 10.1007/s00234-021-02821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
J-difference-edited spectroscopy is a valuable approach for the detection of low-concentration metabolites with magnetic resonance spectroscopy (MRS). Currently, few edited MRS studies are performed in neonates due to suboptimal signal-to-noise ratio, relatively long acquisition times, and vulnerability to motion artifacts. Nonetheless, the technique presents an exciting opportunity in pediatric imaging research to study rapid maturational changes of neurotransmitter systems and other metabolic systems in early postnatal life. Studying these metabolic processes is vital to understanding the widespread and rapid structural and functional changes that occur in the first years of life. The overarching goal of this review is to provide an introduction to edited MRS for neonates, including the current state-of-the-art in editing methods and editable metabolites, as well as to review the current literature applying edited MRS to the neonatal brain. Existing challenges and future opportunities, including the lack of age-specific reference data, are also discussed.
Collapse
Affiliation(s)
- Yulu Song
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Peter J Lally
- Department of Brain Sciences, Imperial College London, London, UK
| | - Maria Yanez Lopez
- Center for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Mary Beth Nebel
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Borjan Gagoski
- Department of Radiology, Division of Neuroradiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA
| | | | - Steve C N Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Helge J Zöllner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Deepika Shukla
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, UK
| | - Tomoki Arichi
- Center for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Department of Bioengineering, Imperial College London, South Kensington Campus, London, UK
| | - Enrico De Vita
- Center for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, St Thomas's Hospital, Westminster Bridge Road, Lambeth Wing, 3rd Floor, London, SE1 7EH, UK
| | - Vivek Yedavalli
- Division of Neuroradiology, Park 367G, The Johns Hopkins University School of Medicine, 600 N. Wolfe St. B-112 D, Baltimore, MD, 21287, USA
| | - Sudhin Thayyil
- Centre for Perinatal Neuroscience, Department of Brain Sciences, Imperial College London, London, UK
| | - Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins University, Baltimore, USA.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Douglas C Dean
- Waisman Center, University of WI-Madison, Madison, WI, 53705, USA.,Department of Pediatrics, Division of Neonatology and Newborn Nursery, University of WI-Madison, School of Medicine and Public Health, Madison, WI, 53705, USA.,Department of Medical Physics, University of WI-Madison, School of Medicine and Public Health, Madison, WI, 53705, USA
| | - P Ellen Grant
- Department of Radiology, Division of Neuroradiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, USA.,Department of Medicine, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessica L Wisnowski
- Children's Hospital Los Angeles, Los Angeles, CA, 90027, USA.,Department of Radiology and Fetal and Neonatal Institute, CHLA Division of Neonatology, Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA, 90033, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA. .,Division of Neuroradiology, Park 367G, The Johns Hopkins University School of Medicine, 600 N. Wolfe St. B-112 D, Baltimore, MD, 21287, USA.
| |
Collapse
|
6
|
Elshal FIS, Elshehaby WA, Dawoud MAE, Shaban EA. Magnetic resonance imaging and spectroscopy in evaluation of hypoxic ischemic encephalopathy in pediatric age group. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00578-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hypoxic ischemic encephalopathy is a major cause of pediatric mortality and morbidity, with possible long-term neurologic sequel, such as cerebral palsy. With improvements in care of at-risk neonates, more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. The aim of the study was to assess the additive role of magnetic resonance spectroscopy over conventional MRI in diagnosis and early prediction of pathological motor development in neonates with hypoxic ischemic encephalopathy.
Results
MRS ratios showed significant difference between unfavorable and normal outcome infants. MRS ratios as Lac/Cr, NAA/Cr and NAA/Cho within basal ganglia, thalamus and white matter can significantly differentiate between patients with normal and pathological outcome at 1 year.
Lac/Cr positively correlates with the severity of HIE. Both NAA/Cr and NAA/Cho negatively correlate with the severity of the disease. Ratios cutoff values as Lac/Cr above 0.38 and 0.42 in basal ganglia and white matter, respectively, NAA/Cr below 0.9 and 0.8 in basal ganglia and occipital white matter, respectively, and NAA/Cho below 0.29 and 0.31 in basal ganglia and frontal white matter, respectively, were significantly predictive of pathological outcome.
Conclusion
High Lac/Cr, low NAA/Cr and low NAA/Cho ratios within examined regions of the brain including deep grey matter nuclei as well as white matter are associated with an adverse outcome in infants with perinatal asphyxia. MRS is an accurate quantitative MR biomarker within the neonatal period for prediction of neurodevelopmental outcome after perinatal HIE. MRS may be useful in early clinical management decisions, and counseling parents thereby ensuring appropriate early intervention and rehabilitation.
Collapse
|
7
|
Evaluation of Altered Glutamatergic Activity in a Piglet Model of Hypoxic-Ischemic Brain Damage Using 1H-MRS. DISEASE MARKERS 2020; 2020:8850816. [PMID: 33029259 PMCID: PMC7532412 DOI: 10.1155/2020/8850816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/05/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022]
Abstract
Methods Twenty-five newborn piglets were selected and then randomly assigned to the control group (n = 5) and the model group (n = 20) subjected to HI. HI was induced by blocking bilateral carotid blood flow under simultaneous inhalation of a 6% oxygen mixture. 1H-MRS data were acquired from the basal ganglia at the following time points after HI: 6, 12, 24, and 72 h. Changes in protein levels of EAAT2 and GluR2 were determined by immunohistochemical analysis. Correlations among metabolite concentrations, metabolite ratios, and the protein levels of EAAT2 and GluR2 were investigated. Results The Glu level sharply increased after HI, reached a transient low level of depletion that approached the normal level in the control group, and subsequently increased again. Negative correlations were found between concentrations of Glu and EAAT2 protein levels (R s = -0.662, P < 0.001) and between the Glu/creatine (Cr) ratio and EAAT2 protein level (R s = -0.664, P < 0.001). Moreover, changes in GluR2 protein level were significantly and negatively correlated with those in Glu level (the absolute Glu concentration, R s = -0.797, P < 0.001; Glu/Cr, R s = -0.567, P = 0.003). Conclusions Changes in Glu level measured by 1H-MRS were inversely correlated with those in EAAT2 and GluR2 protein levels following HI, and the results demonstrated that 1H-MRS can reflect the early changes of glutamatergic activity in vivo.
Collapse
|
8
|
Mikrogeorgiou A, Xu D, Ferriero DM, Vannucci SJ. Assessing Cerebral Metabolism in the Immature Rodent: From Extracts to Real-Time Assessments. Dev Neurosci 2019; 40:463-474. [PMID: 30991389 DOI: 10.1159/000496921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/09/2019] [Indexed: 12/27/2022] Open
Abstract
Brain development is an energy-expensive process. Although glucose is irreplaceable, the developing brain utilizes a variety of substrates such as lactate and the ketone bodies, β-hydroxybutyrate and acetoacetate, to produce energy and synthesize the structural components necessary for cerebral maturation. When oxygen and nutrient supplies to the brain are restricted, as in neonatal hypoxia-ischemia (HI), cerebral energy metabolism undergoes alterations in substrate use to preserve the production of adenosine triphosphate. These changes have been studied by in situ biochemical methods that yielded valuable quantitative information about high-energy and glycolytic metabolites and established a temporal profile of the cerebral metabolic response to hypoxia and HI. However, these analyses relied on terminal experiments and averaging values from several animals at each time point as well as challenging requirements for accurate tissue processing.More recent methodologies have focused on in vivo longitudinal analyses in individual animals. The emerging field of metabolomics provides a new investigative tool for studying cerebral metabolism. Magnetic resonance spectroscopy (MRS) has enabled the acquisition of a snapshot of the metabolic status of the brain as quantifiable spectra of various intracellular metabolites. Proton (1H) MRS has been used extensively as an experimental and diagnostic tool of HI in the pursuit of markers of long-term neurodevelopmental outcomes. Still, the interpretation of the metabolite spectra acquired with 1H MRS has proven challenging, due to discrepancies among studies, regarding calculations and timing of measurements. As a result, the predictive utility of such studies is not clear. 13C MRS is methodologically more challenging, but it provides a unique window on living tissue metabolism via measurements of the incorporation of 13C label from substrates into brain metabolites and the localized determination of various metabolic fluxes. The newly developed hyperpolarized 13C MRS is an exciting method for assessing cerebral metabolism in vivo, that bears the advantages of conventional 13C MRS but with a huge gain in signal intensity and much shorter acquisition times. The first part of this review article provides a brief description of the findings of biochemical and imaging methods over the years as well as a discussion of their associated strengths and pitfalls. The second part summarizes the current knowledge on cerebral metabolism during development and HI brain injury.
Collapse
Affiliation(s)
- Alkisti Mikrogeorgiou
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Donna M Ferriero
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Neurology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Susan J Vannucci
- Department of Pediatrics and Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA,
| |
Collapse
|
9
|
Shibasaki J, Aida N, Morisaki N, Tomiyasu M, Nishi Y, Toyoshima K. Changes in Brain Metabolite Concentrations after Neonatal Hypoxic-ischemic Encephalopathy. Radiology 2018; 288:840-848. [PMID: 29893645 DOI: 10.1148/radiol.2018172083] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the time-course changes and predictive utility of brain metabolite concentrations in neonatal hypoxic-ischemic encephalopathy (HIE). Materials and Methods Sixty-eight neonates (age, 35-41 gestational weeks) with HIE were admitted to a neonatal intensive care unit between September 2009 and March 2016 and examined by using proton MR spectroscopy at 18-96 hours (n = 25) and 7-14 days (n = 64) after birth (35-43 postmenstrual weeks) to estimate metabolite concentrations in the deep gray matter. Adverse outcome was defined as death or neurodevelopmental impairment at 18-22 months of age. Areas under the receiver operating characteristic curves were calculated to evaluate the prognostic values of metabolites. Results At 18-96 hours, N-acetylaspartate and creatine concentrations were lower, whereas lactate, and glutamate and glutamine (Glx) concentrations were higher in neonates with adverse outcomes than in those with favorable outcomes. Metabolite concentrations at 18-96 hours decreased during days 7-14 in neonates with adverse outcomes but did not change in those with favorable outcomes. For N-acetylaspartate, creatine, lactate, and Glx concentrations measured at 18-96 hours to predict adverse outcomes, areas under the receiver operating characteristic curve were 0.98, 0.89, 0.96, and 0.88, respectively, whereas at 7-14 days, the areas under the receiver operating characteristic curve were 0.97, 0.97, 0.59, and 0.36, respectively. Conclusion Time-dependent reductions in N-acetylaspartate and creatine concentrations at both 18-96 hours and 7-14 days accurately predicted adverse outcomes. However, higher lactate and glutamate and glutamine concentrations were often transient.
Collapse
Affiliation(s)
- Jun Shibasaki
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| | - Noriko Aida
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| | - Naho Morisaki
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| | - Moyoko Tomiyasu
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| | - Yuri Nishi
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| | - Katsuaki Toyoshima
- From the Departments of Neonatology (J.S., K.T.) and Radiology (N.A., M.T., Y.N.), Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan (N.A., M.T.); Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan (N.M.); and Research Center for Child Mental Development, Chiba University, Chiba, Japan (M.T.)
| |
Collapse
|
10
|
Dokumacı DŞ, Doğan F, Yıldırım A, Boyacı FN, Bozdoğan E, Koca B. Brain metabolite alterations in Eisenmenger syndrome: Evaluation with MR proton spectroscopy. Eur J Radiol 2016; 86:70-75. [PMID: 28027769 DOI: 10.1016/j.ejrad.2016.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Eisenmenger syndrome (ES) is a life-threatening disease characterized by pulmonary hypertension and cyanosis in patients with congenital heart diseases. The aim of this study was to determine the brain metabolite changes in Eisenmenger syndrome compared with a control group using MR proton spectroscopy. METHODS AND MATERIALS The study included 10 children (3 male, 7 female) with congenital heart diseases and a diagnosis of Eisenmenger syndrome. The control group consisted of 10 healthy volunteer children. All were examined with a 1.5T MRI scanner and single voxel spectroscopy was performed to obtain spectra from three different regions; left frontal subcortical white matter, left lentiform nucleus and left thalamus. Peak integral values obtained from the spectra were used as quantitative data. RESULTS The ages of the children with ES were between 5 and 16 years, and between 5 and 15 years in the control group. Periventricular white matter hyperintensities were observed in 3 patients. On MR spectroscopy study, significantly lower levels of Choline metabolite (Cho) were detected in the frontal subcortical region and thalamus regions of the patients compared with the control group. There was no statistically significant difference between the levels of other metabolites (NAA, Cr, mI and Glx). In the lentiform nucleus, although the average value of Cho in ES patients was lower than that of the control group, it was not statistically significant. CONCLUSION Cho metabolite was determined to have an important role in brain metabolism in Eisenmenger syndrome patients. Oral Cho treatment may help to extend survival.
Collapse
Affiliation(s)
- Dilek Şen Dokumacı
- Harran University School of Medicine, Department of Radiology, Sanliurfa, Turkey.
| | - Ferit Doğan
- Children Hospital, Department of Radiology, Sanliurfa, Turkey
| | - Ali Yıldırım
- Children Hospital, Department of Pediatric Cardiology, Sanliurfa, Turkey
| | | | - Erol Bozdoğan
- Harran University School of Medicine, Department of Radiology, Sanliurfa, Turkey
| | - Bülent Koca
- Harran University School of Medicine, Department of Pediatric Cardiology, Sanliurfa, Turkey
| |
Collapse
|
11
|
Xu S, Waddell J, Zhu W, Shi D, Marshall AD, McKenna MC, Gullapalli RP. In vivo longitudinal proton magnetic resonance spectroscopy on neonatal hypoxic-ischemic rat brain injury: Neuroprotective effects of acetyl-L-carnitine. Magn Reson Med 2015; 74:1530-42. [PMID: 25461739 PMCID: PMC4452442 DOI: 10.1002/mrm.25537] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 10/04/2014] [Accepted: 10/30/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE This study evaluated the longitudinal metabolic alterations after neonatal hypoxia-ischemia (HI) in rats and tested the neuroprotective effect of acetyl-L-carnitine (ALCAR) using in vivo proton short-TE Point-RESolved Spectroscopy method. METHODS Rice-Vannucci model was used on 7-day-old Sprague-Dawley rats. Data were acquired from contralateral and ipsilateral cortex and hippocampus, respectively at 4 time points (24-h, 72-h, 7-days, 28-days) post-HI. The effect of subcutaneous administration of ALCAR (100 mg/kg) immediately after HI, at 4-h, 24-h, and 48-h post-HI was determined. RESULTS Significant reductions in glutathione (P < 0.005), myo-inositol (P < 0.002), taurine (P < 0.001), and total creatine (P < 0.005) were observed at 24-h postinjury compared with the control group in the ipsilateral hippocampus of the HI rat pups. ALCAR-treated-HI rats had lower levels of lactate and maintained total creatine at 24-h and had smaller lesion size compared with the HI only rats. CONCLUSION Severe oxidative, osmotic stress, impaired phosphorylation, and a preference for anaerobic glycolysis were found in the ipsilateral hippocampus in the HI pups at 24-h postinjury. ALCAR appeared to have a neuroprotective effect if administered early after HI by serving as an energy substrate and promote oxidative cerebral energy producing and minimize anaerobic glycolysis.
Collapse
Affiliation(s)
- Su Xu
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Core for Translational Research in Imaging @ Maryland, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Jaylyn Waddell
- Department of Pediatrics and Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Wenjun Zhu
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Core for Translational Research in Imaging @ Maryland, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Da Shi
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Andrew D Marshall
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Core for Translational Research in Imaging @ Maryland, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mary C McKenna
- Department of Pediatrics and Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Rao P Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Core for Translational Research in Imaging @ Maryland, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| |
Collapse
|
12
|
Shemesh N, Rosenberg JT, Dumez JN, Grant SC, Frydman L. Metabolic T1 dynamics and longitudinal relaxation enhancement in vivo at ultrahigh magnetic fields on ischemia. J Cereb Blood Flow Metab 2014; 34:1810-7. [PMID: 25204392 PMCID: PMC4269758 DOI: 10.1038/jcbfm.2014.149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/25/2014] [Accepted: 07/28/2014] [Indexed: 01/02/2023]
Abstract
Interruptions in cerebral blood flow may lead to devastating neural outcomes. Magnetic resonance has a central role in diagnosing and monitoring these insufficiencies, as well as in understanding their underlying metabolic consequences. Magnetic resonance spectroscopy (MRS) in particular can probe ischemia via the signatures of endogenous metabolites including lactic acid (Lac), N-acetylaspartate, creatine (Cre), and cholines. Typically, MRS reports on these metabolites' concentrations. This study focuses on establishing the potential occurrence of in vivo longitudinal relaxation enhancement (LRE) effects-a phenomenon involving a reduction of the apparent T1 with selective bandwidth excitations- in a rat stroke model at 21.1 T. Statistically significant reductions in Cre's apparent T1s were observed at all the examined post-ischemia time points for both ipsi- and contralateral hemispheres, thereby establishing the existence of LREs for this metabolite in vivo. Ischemia-dependent LRE trends were also noted for Lac in the ipsilateral hemisphere only 24 hours after ischemia. Metabolic T1s were also found to vary significantly as a function of post-stroke recovery time, with the most remarkable and rapid changes observed for Lac T1s. The potential of such measurements to understand stroke at a molecular level and assist in its diagnosis, is discussed.
Collapse
Affiliation(s)
- Noam Shemesh
- Department of Chemical Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Jens T Rosenberg
- 1] National High Magnetic Field Laboratory, The Florida State University, Tallahassee, Florida, USA [2] Chemical & Biomedical Engineering, The Florida State University, Tallahassee, Florida, USA
| | - Jean-Nicolas Dumez
- Department of Chemical Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Samuel C Grant
- 1] National High Magnetic Field Laboratory, The Florida State University, Tallahassee, Florida, USA [2] Chemical & Biomedical Engineering, The Florida State University, Tallahassee, Florida, USA
| | - Lucio Frydman
- 1] Department of Chemical Physics, Weizmann Institute of Science, Rehovot, Israel [2] National High Magnetic Field Laboratory, The Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
13
|
Degraeuwe PL, Jaspers GJ, Robertson NJ, Kessels AG. Magnetic resonance spectroscopy as a prognostic marker in neonatal hypoxic-ischemic encephalopathy: a study protocol for an individual patient data meta-analysis. Syst Rev 2013; 2:96. [PMID: 24156407 PMCID: PMC4016296 DOI: 10.1186/2046-4053-2-96] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 10/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognostic accuracy of 1H (proton) magnetic resonance spectroscopy (MRS) in neonatal hypoxic-ischemic encephalopathy has been assessed by a criticized study-based meta-analysis. An individual patient data meta-analysis may overcome some of the drawbacks encountered in the aggregate data meta-analysis. Moreover, the prognostic marker can be assessed quantitatively and the effect of covariates can be estimated. METHODS Diagnostic accuracy studies relevant to the study topic were retrieved. The primary authors will be invited to share the raw de-identified study data. These individual patient data will be analyzed using logistic regression analysis. A prediction tool calculating the individualized risk of very adverse outcome will be devised. DISCUSSION The proposed individual patient data meta-analysis provides several advantages. Inclusion and exclusion criteria can be applied more uniformly. Furthermore, adjustment is possible for confounding factors and subgroup analyses can be conducted. Our goal is to develop a prediction model for outcome in newborns with hypoxic-ischemic encephalopathy.
Collapse
Affiliation(s)
- Pieter Lj Degraeuwe
- Department of Pediatrics, Maastricht University Medical Centre, P, Debyelaan 25, PO Box 5800, 6202AZ Maastricht, The Netherlands.
| | | | | | | |
Collapse
|
14
|
Abstract
CLINICAL/METHODICAL ISSUE Evaluation of the normal and pathological fetal brain. STANDARD RADIOLOGICAL METHODS Magnetic resonance imaging (MRI). METHODICAL INNOVATIONS Advanced MRI of the fetal brain. PERFORMANCE Diffusion tensor imaging (DTI) is used in clinical practice, all other methods are used at a research level. ACHIEVEMENTS Serving as standard methods in the future. PRACTICAL RECOMMENDATIONS Combined structural and functional data for all gestational ages will allow more specific insight into the developmental processes of the fetal brain. This gain of information will help provide a common understanding of complex spatial and temporal procedures of early morphological features and their impact on cognitive and sensory abilities.
Collapse
|
15
|
Corbo ET, Bartnik-Olson BL, Machado S, Merritt TA, Peverini R, Wycliffe N, Ashwal S. The effect of whole-body cooling on brain metabolism following perinatal hypoxic-ischemic injury. Pediatr Res 2012; 71:85-92. [PMID: 22289855 DOI: 10.1038/pr.2011.8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) and spectroscopy (MRS) have proven valuable in evaluating neonatal hypoxic-ischemic injury (HII). RESULTS MRI scores in the basal ganglia of HII/HT(+) neonates were significantly lower than HII/HT(-) neonates, indicating less severe injury and were associated with lower discharge encephalopathy severity scores in the HII/HT(+) group (P = 0.01). Lactate (Lac) was detected in the occipital gray matter (OGM) and thalamus (TH) of significantly more HII/HT(-) neonates (31.6 and 35.3%) as compared to the HII/HT(+) group (10.5 and 15.8%). In contrast, the -N-acetylaspartate (NAA)-based ratios in the OGM and TH did not differ between the HII groups. DISCUSSION Our data show that the HT was associated with a decrease in the number of HII neonates with detectable cortical and subcortical Lac as well as a decrease in the number of MRI-detectable subcortical lesions. METHODS We retrospectively compared the medical and neuroimaging data of 19 HII neonates who received 72 h of whole-body cooling (HII/HT(+)) with those of 19 noncooled HII neonates (HII/HT(-)) to determine whether hypothermia was associated with improved recovery from the injury as measured by MRI and MRS within the first 14 days of life. MRI scores and metabolite ratios of HII/HT(+) and HII/HT(-) neonates were also compared with nine healthy, nonasphyxiated "control" neonates.
Collapse
Affiliation(s)
- Elizabeth T Corbo
- Department of Pediatric Neurology, Loma Linda University Medical Center, Loma Linda, California, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
The prognostic value of multivoxel magnetic resonance spectroscopy determined metabolite levels in white and grey matter brain tissue for adverse outcome in term newborns following perinatal asphyxia. Eur Radiol 2011; 22:772-8. [PMID: 22057247 PMCID: PMC3297743 DOI: 10.1007/s00330-011-2315-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 09/06/2011] [Accepted: 10/06/2011] [Indexed: 11/06/2022]
Abstract
Objective Magnetic resonance spectroscopy can identify brain metabolic changes in perinatal asphyxia by providing ratios of metabolites, such as choline (Cho), creatine (Cr), N-acetyl aspartate (NAA) and lactate (Lact) [Cho/Cr, Lact/NAA, etc.]. The purpose of this study was to quantify the separate white and grey matter metabolites in a slab cranial to the ventricles and relate these to the outcome. Methods A standard 2D-chemical shift imaging protocol was used for measuring a transverse volume of interest located cranial to the ventricles allowing for direct comparison of the metabolites in white and grey matter brain tissue in 24 term asphyxiated newborns aged 3 to 16 days. Results Cho, NAA and Lact showed significant differences between four subgroups of asphyxiated infants with more and less favourable outcomes. High levels of Cho and Lact in the grey matter differentiated non-survivors from survivors (P = 0.003 and P = 0.017, respectively). Conclusion In perinatal asphyxia the levels of Cho, NAA and Lact in both white and grey matter brain tissue are affected. The levels of Cho and Lact measured in the grey matter are the most indicative of survival. It is therefore advised to include grey matter brain tissue in the region of interest examined by multivoxel MR spectroscopy. Key Points • Magnetic resonance spectroscopy can identify brain metabolic changes in perinatal asphyxia. • Choline and lactate levels in grey matter seem the best indicators of survival. • Both grey and white matter should be examined during spectroscopy for perinatal asphyxia.
Collapse
|
17
|
Charles-Edwards GD, Jan W, To M, Maxwell D, Keevil SF, Robinson R. Non-invasive detection and quantification of human foetal brain lactate in utero by magnetic resonance spectroscopy. Prenat Diagn 2010; 30:260-6. [PMID: 20120007 DOI: 10.1002/pd.2463] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the feasibility of foetal cerebral lactate detection and quantification by proton magnetic resonance spectroscopy ((1)H-MRS) in pregnancies at increased risk of cerebral hypoxia, using a clinical 1.5 T magnetic resonance imaging (MRI) system. METHOD Localised (1)H-MRS was performed in four patients with pregnancies in their third trimester complicated by intrauterine growth restriction (IUGR). A long echo time (TE) of 288 ms was used to maximise detection and conspicuity of the lactate methyl resonance, together with a short TE MRS acquisition to check for the presence of lipid contamination. Individual peaks in the resulting spectra were measured, corrected for relaxation and referenced to the unsuppressed water signal to provide metabolite concentrations. RESULTS A resonance peak consistent with the presence of lactate was observed in all cases. In one subject, this was confounded by the identification of significant lipid contamination in the short TE MRS acquisition. The range of measured lactate concentrations was 2.0-3.3 mmol/kg and compared well with preterm neonatal MRS studies. CONCLUSION The non-invasive detection and quantification of foetal cerebral lactate by MRS is achievable on a clinical 1.5 T MRI system.
Collapse
|
18
|
Pugash D, Krssak M, Kulemann V, Prayer D. Magnetic resonance spectroscopy of the fetal brain. Prenat Diagn 2009; 29:434-41. [DOI: 10.1002/pd.2248] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
19
|
Meyer-Witte S, Brissaud O, Brun M, Lamireau D, Bordessoules M, Chateil JF. [Prognostic value of MR in term neonates with neonatal hypoxic-ischemic encephalopath: MRI score and spectroscopy. About 26 cases]. Arch Pediatr 2007; 15:9-23. [PMID: 18164915 DOI: 10.1016/j.arcped.2007.08.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2006] [Revised: 07/20/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
Abstract
UNLABELLED Neonatal hypoxic-ischemic encephalopathy remains a major cause of chronic disability in childhood. Early diagnosis and prognosis are necessary for the clinician to adapt the treatment. However, there is yet no reliable test to predict the patient's evolution. OBJECTIVE The aim of our study was to evaluate the predictive value of a personal magnetic resonance imaging (MRI) scoring system and of magnetic resonance spectroscopy (MRS). MATERIAL AND METHODS We included 26 term newborns in condition of neonatal brain suffering. MR examination was performed during the first week of life for all patients and MRI and MRS data were collected. Standardised follow-up visits were made for all patients. Finally, prognostic value of the different criteria was evaluated with statistical tests. RESULTS Our MRI scoring system proved to be linked to prognosis. A high MRI score, abnormal signal in the internal capsule, white matter or basal ganglia abnormalities with diffusion imaging were associated with unfavourable outcome. These results confirmed the data of the literature concerning the MRI predictive value. Our study also confirmed prognostic interest of MR: particularly, ratios using lactate were significantly linked to prognosis in our study. Specificity of the elevation of these ratios was interesting but sensibility was less optimal. CONCLUSION We suggest using our MRI scoring system which associates standard MRI and diffusion imaging, which is significantly related to outcome. We confirm the prognostic value of MRS in this pathological situation. MR with diffusion sequence and spectroscopy, performed three to four days after birth appears to be an essential tool to manage these patients.
Collapse
Affiliation(s)
- S Meyer-Witte
- Service de neuropédiatrie, hôpital Pellegrin, 33076 Bordeaux, France.
| | | | | | | | | | | |
Collapse
|
20
|
Tsai SY, Posse S, Lin YR, Ko CW, Otazo R, Chung HW, Lin FH. Fast mapping of theT2 relaxation time of cerebral metabolites using proton echo-planar spectroscopic imaging (PEPSI). Magn Reson Med 2007; 57:859-65. [PMID: 17457864 DOI: 10.1002/mrm.21225] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Metabolite T2 is necessary for accurate quantification of the absolute concentration of metabolites using long-echo-time (TE) acquisition schemes. However, lengthy data acquisition times pose a major challenge to mapping metabolite T2. In this study we used proton echo-planar spectroscopic imaging (PEPSI) at 3T to obtain fast T2 maps of three major cerebral metabolites: N-acetyl-aspartate (NAA), creatine (Cre), and choline (Cho). We showed that PEPSI spectra matched T2 values obtained using single-voxel spectroscopy (SVS). Data acquisition for 2D metabolite maps with a voxel volume of 0.95 ml (32 x 32 image matrix) can be completed in 25 min using five TEs and eight averages. A sufficient spectral signal-to-noise ratio (SNR) for T2 estimation was validated by high Pearson's correlation coefficients between logarithmic MR signals and TEs (R2 = 0.98, 0.97, and 0.95 for NAA, Cre, and Cho, respectively). In agreement with previous studies, we found that the T2 values of NAA, but not Cre and Cho, were significantly different between gray matter (GM) and white matter (WM; P < 0.001). The difference between the T2 estimates of the PEPSI and SVS scans was less than 9%. Consistent spatial distributions of T2 were found in six healthy subjects, and disagreement among subjects was less than 10%. In summary, the PEPSI technique is a robust method to obtain fast mapping of metabolite T2.
Collapse
Affiliation(s)
- Shang-Yueh Tsai
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | | | | |
Collapse
|
21
|
O'Brien FE, Iwata O, Thornton JS, De Vita E, Sellwood MW, Iwata S, Sakata YS, Charman S, Ordidge R, Cady EB, Wyatt JS, Robertson NJ. Delayed whole-body cooling to 33 or 35 degrees C and the development of impaired energy generation consequential to transient cerebral hypoxia-ischemia in the newborn piglet. Pediatrics 2006; 117:1549-59. [PMID: 16651308 DOI: 10.1542/peds.2005-1649] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Fundamental questions remain about the precise temperature providing optimal neuroprotection after perinatal hypoxia-ischemia (HI). Furthermore, if hypothermia delays the onset of the neurotoxic cascade and the secondary impairment in cerebral energy generation, the "latent phase" may be prolonged, thus extending the period when additional treatments may be effective. The aims of this study were to investigate the effects of delayed systemic cooling at either 33 degrees C or 35 degrees C on the following: (1) latent-phase duration, and (2) cerebral metabolism during secondary energy failure itself, in the 48-hour period after transient HI. METHODS Piglets were randomly assigned to the following: (1) HI-normothermic (HI-n) rectal temperature (Trectal; n = 12), (2) HI-Trectal 35 degrees C (HI-35; n = 7), and (3) HI-Trectal 33 degrees C (HI-33; n = 10). Groups were cooled to the target Trectal between 2 and 26 hours after HI. Serial magnetic resonance spectroscopy was performed over 48 hours. The effect of cooling on secondary energy failure severity (indexed by the nucleotide triphosphate/exchangeable phosphate pool [NTP/EPP] and phosphocreatine/inorganic phosphate [PCr/Pi] ratios) was assessed. RESULTS Compared with HI-n, HI-35 and HI-33 had a longer NTP/EPP latent phase and during the entire study duration had higher mean NTP/EPP and PCr/Pi. The latent phase (both PCr/Pi and NTP/EPP) and the whole-brain cerebral energetics were similar for HI-35 and HI-33. During the hypothermic period, compared with HI-n, PCr/Pi was preserved in the cooled groups, but this advantage was not maintained after rewarming. Compared with HI-n, HI-35 and HI-33 had higher NTP/EPP after rewarming. CONCLUSIONS Whole-body hypothermia for 24 hours at either 35 or 33 degrees C, commenced 2 hours after resuscitation, prolonged the NTP/EPP latent phase and reduced the overall secondary falls in mean PCr/Pi and NTP/EPP during 48 hours after HI. Reducing the temperature from 35 to 33 degrees C neither increased mean PCr/Pi and NTP/EPP nor further lengthened the latent phase.
Collapse
Affiliation(s)
- Frances E O'Brien
- Department of Pediatrics and Child Health, University College London, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Zarifi MK, Astrakas LG, Poussaint TY, Plessis Ad AD, Zurakowski D, Tzika AA. Prediction of adverse outcome with cerebral lactate level and apparent diffusion coefficient in infants with perinatal asphyxia. Radiology 2002; 225:859-70. [PMID: 12461272 DOI: 10.1148/radiol.2253011797] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare the predictive value for adverse outcome of quantitative cerebral lactate level and of apparent diffusion coefficient (ADC) in infants with perinatal asphyxia in the early postnatal period. MATERIALS AND METHODS Lactate-choline ratios determined with proton magnetic resonance (MR) spectroscopy and ADC determined with diffusion MR imaging in basal ganglia and thalami in 26 full-term neonates (age range, 1-10 days) were compared with severity of acute hypoxic-ischemic encephalopathy and long-term clinical outcome. Differences in metabolites between outcome groups were evaluated with the nonparametric Kruskal-Wallis test and the Dunn test. Logistic regression was performed to examine the predictive value of each metabolite for differentiating normal from abnormal or fatal clinical outcome. The likelihood ratio test was used to assess the statistical significance of each metabolite. RESULTS Logistic regression confirmed that lactate-choline ratio could be used to differentiate normal (n = 5) from abnormal (n = 14) or fatal (n = 6) outcome (P <.001). The probability of an adverse outcome exceeded 95% for a lactate-choline ratio of 1.0. Even when analyses were restricted to the early postnatal period, lactate-choline ratio was still a significant predictor of adverse outcome (P =.001). Although ADC images were useful in clinical examination of these infants, quantitative ADCs were not predictive of outcome (P =.82). CONCLUSION Higher lactate-choline ratios in basal ganglia and thalami of infants with perinatal asphyxia were predictive of worse clinical outcomes. Absolute ADC in the same brain regions did not indicate a statistically significant relationship with clinical outcome. Cerebral lactate level is useful in identifying infants who would benefit from early therapeutic intervention.
Collapse
Affiliation(s)
- Maria K Zarifi
- Departments of Radiology, Children's Hospital, Harvard Medical School, Boston, Mass 02114, USA
| | | | | | | | | | | |
Collapse
|
23
|
Moore CM, Bonello CM, Sherwood AR, Cohen BM, Renshaw PF, Yurgulen-Todd DA. Mesial temporal lobe Cho to Cr(PCr) ratio asymmetry in chronic schizophrenics. Schizophr Res 2002; 57:35-42. [PMID: 12165374 DOI: 10.1016/s0920-9964(01)00302-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Proton magnetic resonance spectra (MRS) were acquired from 1.5 x 1.5 x 1.5-cm voxels in the left and right mesial temporal lobes of 20 schizophrenic patients and 20 non-psychiatric comparison subjects. Choline (Cho) to creatine (and phosphocreatine) (Cr(PCr)) ratios were estimated as were the percent gray matter, white matter and CSF contributing to the voxel. The Cho/Cr(PCr) metabolite ratio was significantly lower in the left temporal lobe than in the right temporal lobe for both the schizophrenia subjects and control group. This difference was greater in the schizophrenia subjects. Left temporal lobe gray matter voxel content was significantly higher and white matter content was significantly lower than in the right temporal lobe for both the schizophrenia subjects and control group. This difference was the same for the schizophrenia subjects and control group. Left voxel gray matter and white matter content correlated with Cho/Cr(PCr) metabolite ratios for the schizophrenic subjects but not for the control subjects. No such correlations were noted on the right side. No significant difference was found between Cho/Cr(PCr) in the left temporal lobe or in the right temporal lobe of the schizophrenia subjects vs. the control group.
Collapse
Affiliation(s)
- Constance M Moore
- Brain Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Robertson NJ, Lewis RH, Cowan FM, Allsop JM, Counsell SJ, Edwards AD, Cox IJ. Early increases in brain myo-inositol measured by proton magnetic resonance spectroscopy in term infants with neonatal encephalopathy. Pediatr Res 2001; 50:692-700. [PMID: 11726726 DOI: 10.1203/00006450-200112000-00011] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Our aim was to assess brain myo-inositol/creatine plus phosphocreatine (Cr) in the first week in term infants with neonatal encephalopathy using localized short echo time proton magnetic resonance spectroscopy and to relate this to measures of brain injury, specifically lactate/Cr in the first week, basal ganglia changes on magnetic resonance imaging (MRI), and neurodevelopmental outcome at 1 y. Fourteen term infants with neonatal encephalopathy of gestational age (mean +/- SD) 39.6 +/- 1.6 wk, birth weight 3270 +/- 490 g, underwent MRI and magnetic resonance spectroscopy at 3.5 +/- 2.1 d. Five infants were entered in a pilot study of treatment with moderate whole-body hypothermia for neonatal encephalopathy; two were being cooled at the time of the scan. T(1)- and T(2)-weighted transverse magnetic resonance images were graded as normal or abnormal according to the presence or absence of the normal signal intensity of the posterior limb of the internal capsule and signal intensity changes in the basal ganglia. Localized proton magnetic resonance spectroscopy data were obtained from an 8-cm(3) voxel in the basal ganglia using echo times of 40 and 270 ms, and the peak area ratios of myo-inositol/Cr and lactate/Cr were measured. Outcome was scored using Griffith's development scales and neurodevelopmental examination at 1 y. MRI and outcome were normal in six infants and abnormal in eight. myo-Inositol/Cr and lactate/Cr were higher in infants with abnormal MRI and outcome (p < 0.01, p < 0.01, respectively). myo-Inositol/Cr and lactate/Cr were correlated (p < 0.01) and were both correlated to the Griffith's developmental scales (p < 0.01, p < 0.01, respectively). In conclusion, these preliminary data suggest that early increases in brain basal ganglia myo-inositol/Cr in infants with neonatal encephalopathy are associated with increased lactate/Cr, MRI changes of severe injury, and a poor neurodevelopmental outcome at 1 y.
Collapse
Affiliation(s)
- N J Robertson
- Department of Paediatrics, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Hammersmith Hospital Campus, London W12 0HS, United Kingdom.
| | | | | | | | | | | | | |
Collapse
|
25
|
Huppi PS, Inder TE. Magnetic resonance techniques in the evaluation of the perinatal brain: recent advances and future directions. SEMINARS IN NEONATOLOGY : SN 2001; 6:195-210. [PMID: 11483024 DOI: 10.1053/siny.2001.0039] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Magnetic resonance (MR) techniques are attractive for use in the developing brain because of their resolving power and their relative noninvasiveness. Their ability to provide detailed structural as well as metabolic and functional information without the use of ionizing radiation is unique. Conventional MR Imaging has widely proven its potential for identifying normal and pathologic brain morphology. Functional MR imaging such as diffusion-weighted imaging (DWI) and perfusion and blood-oxygenation-dependent BOLD imaging are newer imaging methods providing insights into brain physiology. This review will focus on the application of different MR techniques including the conventional structural MR imaging techniques and the more advanced MR techniques, such as the quantitative morphometric MR methods, the diffusion weighted MR techniques, the functional MR techniques and MR spectroscopy in the study of the fetal and newborn brain.
Collapse
Affiliation(s)
- P S Huppi
- Department of Paediatrics, Childrens Hospital, University of Geneva, Geneva, Switzerland
| | | |
Collapse
|
26
|
Affiliation(s)
- P S Hüppi
- Child Development Unit, Department of Pediatrics, University Hospital of Geneva, Switzerland
| | | |
Collapse
|
27
|
De Stefano N, Dotti MT, Mortilla M, Federico A. Magnetic resonance imaging and spectroscopic changes in brains of patients with cerebrotendinous xanthomatosis. Brain 2001; 124:121-31. [PMID: 11133792 DOI: 10.1093/brain/124.1.121] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cerebrotendinous xanthomatosis (CTX) is a rare disorder due to an inherited defect in the metabolic pathway of cholesterol. Early diagnosis of the disease is particularly important as patients benefit from therapy with chenodeoxycholic acid. Although the disease is clinically characterized by the concomitant presence of tendon xanthomas, juvenile cataracts and progressive neurological impairment, clinical features may vary greatly. Neuroradiological studies have suggested that the bilateral abnormality of the dentate nuclei could be typical of this disease. However, this finding has been seen inconsistently on conventional MRI. The dynamic of the CNS pathology in CTX is complex, and whether demyelination or axonopathy has primary importance in the pathogenesis of CTX pathology is not known. To clarify both neuroradiological and pathological issues, we performed combined brain MRI and spectroscopy examinations on 12 CTX patients. On conventional MRIs, bilateral hyperintensities of the dentate nuclei were clearly seen in nine out of 12 patients on T(2) -weighted MRIs, but were evident in all patients using a FLAIR sequence. On proton magnetic resonance (MR) spectroscopy, significant decreases in N: -acetylaspartate resonance intensities (P: <0.0001) and increases in lactate MR signals (P<0.05) were found in the group of CTX patients in large volumes of interest localized above the lateral brain ventricles and in the cerebellar hemispheres. Cerebral values of N -acetylaspartate resonance intensities showed a close correlation with patients' disability (Spearman rank correlation = -0.78, P<0.005). These results suggest that MR abnormalities in the dentate nuclei may be evident consistently in patients with CTX. Proton MR spectroscopy data demonstrated widespread axonal damage (as shown by the decrease in N -acetylaspartate) and diffuse brain mitochondrial dysfunction (as shown by the increase in brain parenchymal lactate) in patients with CTX. The close correlation seen between values of the putative axonal marker N-acetylaspartate and patients' disability scores suggests that proton MR spectroscopy can provide a useful measure of disease outcome in CTX.
Collapse
Affiliation(s)
- N De Stefano
- Institute of Neurological Sciences, Neurometabolic Unit, NMR Centre and Centre for the Diagnosis, Prevention and Therapy of Neuro-handicap, University of Siena, Italy
| | | | | | | |
Collapse
|
28
|
Christensen JD, Kaufman MJ, Frederick B, Rose SL, Moore CM, Lukas SE, Mendelson JH, Cohen BM, Renshaw PF. Proton magnetic resonance spectroscopy of human basal ganglia: response to cocaine administration. Biol Psychiatry 2000; 48:685-92. [PMID: 11032980 DOI: 10.1016/s0006-3223(00)00897-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Proton magnetic resonance spectroscopy was used to determine the effects of intravenous cocaine or placebo administration on human basal ganglia water and metabolite resonances. METHODS Long echo time, proton magnetic resonance spectra of water and intracellular metabolites were continuously acquired from an 8-cm(3) voxel centered on the left caudate and putamen nuclei before, during, and after the intravenous administration of cocaine or a placebo in a double-blind manner. RESULTS Cocaine, at both 0.2 and 0.4 mg/kg, did not alter the peak area for water. Cocaine at 0.2 mg/kg induced small and reversible increases in choline-containing compounds and N-acetylaspartate peak areas. Cocaine at 0.4 mg/kg induced larger and more sustained increases in choline-containing compounds and N-acetylaspartate peak areas. No changes in either water or metabolite resonances were noted following placebo administration. CONCLUSIONS These increases in choline-containing compounds and N-acetylaspartate peak areas may reflect increases in metabolite T2 relaxation times secondary to osmotic stress and/or increased phospholipid signaling within the basal ganglia following cocaine administration. This is the first report of acute, drug-induced changes in the intensity of human brain proton magnetic resonance spectroscopy resonance areas.
Collapse
Affiliation(s)
- J D Christensen
- Brain Imaging Center, McLean Hospital, Belmont, Massachusetts 02478-9106, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Critchley HD, Simmons A, Daly EM, Russell A, van Amelsvoort T, Robertson DM, Glover A, Murphy DG. Prefrontal and medial temporal correlates of repetitive violence to self and others. Biol Psychiatry 2000; 47:928-34. [PMID: 10807966 DOI: 10.1016/s0006-3223(00)00231-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The neurobiological basis for violence in humans is poorly understood, yet violent behavior (to self or others) is associated with large social and healthcare costs in some groups of patients (e.g., the mentally retarded). The prefrontal cortex and amygdalo-hippocampal complex (AHC) are implicated in the control aggression, therefore we examined the neural integrity of these regions in violent patients with mild mental retardation and nonviolent control subjects. METHODS We used (1)H-magnetic resonance spectroscopy (MRS) to measure 1) concentrations and ratios of N-acetyl aspartate (NAA), creatine phosphocreatine (Cr+PCr), and choline-related compounds (Cho) in prefrontal lobe of 10 violent inpatients and 8 control subjects; 2) ratios of NAA, Cr+PCr, and Cho in the AHC of 13 inpatients and 14 control subjects; and 3) frequency and severity of violence in patients. RESULTS Compared to control subjects, violent patients had significantly (p <.05, analysis of covariance-age and IQ as confounding covariates) lower prefrontal concentrations of NAA and Cr+PCr, and a lower ratio of NAA/Cr+PCr in the AHC. Within the violent patient group, frequency of observed violence to others correlated significantly with prefrontal lobe NAA concentration (r = -0.72, p <.05). CONCLUSIONS NAA concentration indicates neuronal density, and Cr+PCr concentration high-energy phosphate metabolism. Our findings suggest that violent patients with mild mental retardation have reduced neuronal density, and abnormal phosphate metabolism in prefrontal lobe and AHC compared to nonviolent control subjects. Further studies are needed, however, to determine if these findings are regionally specific, or generalize to other groups of violent individuals.
Collapse
|
30
|
Taber KH, Hayman LA, Northrup SR, Maturi L. Vital sign changes during infant magnetic resonance examinations. J Magn Reson Imaging 1998; 8:1252-6. [PMID: 9848737 DOI: 10.1002/jmri.1880080612] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Heart rate (HR) and blood oxygen saturation (SaO2) were monitored before and during clinically indicated MR examinations of newborns to (a) identify any temporal relationship between MR scanning and vital sign fluctuations and (b) assess the reliability of SaO2 monitoring of dynamic changes. Fluctuations in HR (but not in SaO2) that are temporally linked to the MR image acquisition occur in most neonates during routine clinical MR examinations.
Collapse
Affiliation(s)
- K H Taber
- Department of Radiology and the Herbert J. Frensley Center for Imaging Research, Baylor College of Medicine, Houston, TX 77030, USA.
| | | | | | | |
Collapse
|