Energetics and glucose metabolism in hippocampal slices during depolarization: 31P and 13C NMR studies

Limits on activation-induced temperature and metabolic changes in the human primary visual cortex

Changes in cerebral blood flow (CBF) and metabolism are now widely used to map and quantify neural activity, although the underlying mechanism for these changes is still incompletely understood. Magnetic resonance spectroscopy (MRS) at 3T, synchronized with a 32-s block design visual stimulation paradigm, was employed to investigate activation-induced changes in temperature and metabolism in the human primary visual cortex. A marginally significant increase in the local temperature of the visual cortex was found (0.1 degrees C, P = 0.09), excluding the possibility of a temperature decrease (95% confidence interval (CI) = 0.0-0.2 degrees C), which was previously suggested. A comparison with models of thermal equilibrium in the presence of blood flow suggests that an increase in heat production during activation, greater than or at least equal to that produced by the complete oxidative metabolism of the elevated glucose (Glc) utilization accompanying activation, would be required to offset the cooling effects of the increased blood flow. The total pools of glutamate (Glu), glutamine (Gln), myo-Inositol (mI), N-acetylaspartate (NAA), choline (Cho), and lactate (Lac) were not significantly affected by activation. Limits on Lac concentration changes were too weak to constrain theories of the metabolic use of elevated Glc consumption during stimulation, and emphasize the challenges of measuring even large Lac changes accompanying stimulation.

Direct detection of brain acetylcholine synthesis by magnetic resonance spectroscopy

The cholinergic system is an important modulatory neurotransmitter system in the brain. Changes in acetylcholine concentration have been previously determined directly in animal models and human brain biopsy specimens, and indirectly, by the effects of drugs, in living humans. Here, we developed a method for direct determination of acetylcholine synthesis in living brain tissue. The method is based on administration of choline, enriched with carbon-13 (stable isotope) in the two methylene positions, and detection of labeled acetylcholine and all other metabolic fates of choline, by carbon-13 magnetic resonance spectroscopy. We tested this method in rat brain slices and found it to be specific for acetylcholine synthesis in both the cortex and hippocampus. This method is potentially useful as a research tool for exploring the cholinergic system role in cognitive processes and memory storage as well as in diseases in which the malfunction of the cholinergic system has been implicated.

Management of multifactorial idiopathic epilepsy in EL mice with caloric restriction and the ketogenic diet: role of glucose and ketone bodies

BACKGROUND: The high fat, low carbohydrate ketogenic diet (KD) was developed as an alternative to fasting for seizure management. While the mechanisms by which fasting and the KD inhibit seizures remain speculative, alterations in brain energy metabolism are likely involved. We previously showed that caloric restriction (CR) inhibits seizure susceptibility by reducing blood glucose in the epileptic EL mouse, a natural model for human multifactorial idiopathic epilepsy. In this study, we compared the antiepileptic and anticonvulsant efficacy of the KD with that of CR in adult EL mice with active epilepsy. EL mice that experienced at least 15 recurrent complex partial seizures were fed either a standard diet unrestricted (SD-UR) or restricted (SD-R), and either a KD unrestricted (KD-UR) or restricted (KD-R). All mice were fasted for 14 hrs prior to diet initiation. A new experimental design was used where each mouse in the diet-restricted groups served as its own control to achieve a 20-23% body weight reduction. Seizure susceptibility, body weights, and the levels of plasma glucose and beta-hydroxybutyrate were measured once/week over a nine-week treatment period. RESULTS: Body weights and blood glucose levels remained high over the testing period in the SD-UR and the KD-UR groups, but were significantly (p < 0.001) reduced in the SD-R and KD-R groups. Plasma beta-hydroxybutyrate levels were significantly (p < 0.001) increased in the SD-R and KD-R groups compared to their respective UR groups. Seizure susceptibility remained high in both UR-fed groups throughout the study, but was significantly reduced after three weeks in both R-fed groups. CONCLUSIONS: The results indicate that seizure susceptibility in EL mice is dependent on plasma glucose levels and that seizure control is more associated with the amount than with the origin of dietary calories. Also, CR underlies the antiepileptic and anticonvulsant action of the KD in EL mice. A transition from glucose to ketone bodies for energy is predicted to manage EL epileptic seizures through multiple integrated changes of inhibitory and excitatory neural systems.

Perspectives on the metabolic management of epilepsy through dietary reduction of glucose and elevation of ketone bodies

Brain cells are metabolically flexible because they can derive energy from both glucose and ketone bodies (acetoacetate and beta-hydroxybutyrate). Metabolic control theory applies principles of bioenergetics and genome flexibility to the management of complex phenotypic traits. Epilepsy is a complex brain disorder involving excessive, synchronous, abnormal electrical firing patterns of neurons. We propose that many epilepsies with varied etiologies may ultimately involve disruptions of brain energy homeostasis and are potentially manageable through principles of metabolic control theory. This control involves moderate shifts in the availability of brain energy metabolites (glucose and ketone bodies) that alter energy metabolism through glycolysis and the tricarboxylic acid cycle, respectively. These shifts produce adjustments in gene-linked metabolic networks that manage or control the seizure disorder despite the continued presence of the inherited or acquired factors responsible for the epilepsy. This hypothesis is supported by information on the management of seizures with diets including fasting, the ketogenic diet and caloric restriction. A better understanding of the compensatory genetic and neurochemical networks of brain energy metabolism may produce novel antiepileptic therapies that are more effective and biologically friendly than those currently available.

Caloric restriction inhibits seizure susceptibility in epileptic EL mice by reducing blood glucose

PURPOSE

Caloric restriction (CR) involves underfeeding and has long been recognized as a dietary therapy that improves health and increases longevity. In contrast to severe fasting or starvation, CR reduces total food intake without causing nutritional deficiencies. Although fasting has been recognized as an effective antiseizure therapy since the time of the ancient Greeks, the mechanism by which fasting inhibits seizures remains obscure. The influence of CR on seizure susceptibility was investigated at both juvenile (30 days) and adult (70 days) ages in the EL mouse, a genetic model of multifactorial idiopathic epilepsy.

METHODS

The juvenile EL mice were separated into two groups and fed standard lab chow either ad libitum (control, n=18) or with a 15% CR diet (treated, n=17). The adult EL mice were separated into three groups; control (n=15), 15% CR (n=6), and 30% CR (n=3). Body weights, seizure susceptibility, and the levels of blood glucose and ketones (beta-hydroxybutyrate) were measured over a 10-week treatment period. Simple linear regression and multiple logistic regression were used to analyze the relations among seizures, glucose, and ketones.

RESULTS

CR delayed the onset and reduced the incidence of seizures at both juvenile and adult ages and was devoid of adverse side effects. Furthermore, mild CR (15%) had a greater antiepileptogenic effect than the well-established high-fat ketogenic diet in the juvenile mice. The CR-induced changes in blood glucose levels were predictive of both blood ketone levels and seizure susceptibility.

CONCLUSIONS

We propose that CR may reduce seizure susceptibility in EL mice by reducing brain glycolytic energy. Our preclinical findings suggest that CR may be an effective antiseizure dietary therapy for human seizure disorders.

MRI measurement of cell volume fraction in the perfused rat hippocampal slice

T(1)-weighted NMR imaging of the isolated perfused rat hippo-campal slice was used to estimate cell volume fraction. Eight brain slices were studied in artificial cerebrospinal fluid (aCSF) using a 600 MHz narrow bore spectrometer and a home built perfusion chamber. Cell volume fraction was calculated as 1 - f(ECS), where f(ECS) is the distribution volume of gadodiamide in the slice. This was determined by measuring the T(1) of the slice before and after perfusion with gadodiamde. A mean cell volume fraction of 0.66 +/- 0. 04 was estimated. The addition of 60 mM mannitol to three of the brain slices produced a 26% decrease in the cell volume fraction. The technique affords a simple means of estimating cell volume fraction and can be extended to produce images reflecting cell density. Magn Reson Med 42:603-607, 1999.

pH regulation in horizontal cells of the skate retina

To examine the mechanisms by which horizontal cells regulate intracellular pH (pHi), measurements were recorded from isolated cells enzymatically dissociated from the skate retina utilizing the pH-sensitive dye BCECF. In a HCO3--containing Ringer solution, steady-state pHi was 7.32+/-0.13 (mean+/-S.D., n=70). Recovery from acidification was examined using the NH4+ prepulse technique. When NH4+ was removed from the extracellular solution, pHi dropped rapidly to approximately 0.3 pH units below the initial baseline, and then recovered at an initial rate of approximately 0.072 pH units/min. During recovery of pHi after the acid load, the removal of Na+ or the addition of amiloride from a HCO3--free extracellular solution reduced the rate of recovery by 79%+/-11% and 69%+/-14%, respectively. In the presence of DIDS, which inhibits primarily anion transport, or during the removal of Na+, the recovery from acidification was reduced by 83%+/-10% and 70%+/-11%, respectively, as compared to the control value in HCO3--containing solution. These results suggest that the skate horizontal cell possesses a Na/H exchanger as well as a Na+-and HCO3--dependent mechanism for removal of excess acid. Removal of HCO3- or Cl- from the extracellular solution had little effect on pHi, but removing external Na+ induced a marked decrease in pHi that fell at an initial rate of approximately 0.3 pH units min-1. This rate of acidification was decreased by 58%+/-19% in the presence of DIDS (500 micron) and reduced by 28%+/-13% with the addition of amiloride (2 mm). Thus, Na- and HCO3-dependent transport was about 2-fold more active than Na/H exchange during low Na+-induced acidification. The intrinsic pH-buffer capacity, determined from the pHi change induced by incremental reductions in the [NH4+] of the extracellular solution, was 24.2 mm/pH unit at the horizontal cell's resting pHi. Moreover, pHi was relatively insensitive to changes in membrane potential; in experiments under whole-cell voltage clamp (-70 mV), intracellular pH remained constant during depolarizing voltage swings to -30 mV or +30 mV, as well as during hyperpolarizing pulses to -90 or -110 mV.

A fluorescence technique to measure intracellular pH of single neurons in brainstem slices

We have developed a technique to measure the pH, of single neurons in brainstem slices using a fluorescence imaging system. Slices were loaded with the pH-sensitive fluorescent dye BCECF and fluorescence was visualized by exciting the slices alternately at 500 and 440 nm. The emitted fluorescence at 530 nm was directed through an MTI GenIISys image intensifier and MT1 CCD72 camera. The images were processed by image-1/FL software. The ratio of emitted fluorescence at excitation wavelengths of 500 and 440 nm was measured and converted to pH by constructing a calibration curve using high K+/nigericin solutions at pH values ranging from 5.8 to 8.6. BCECF-loaded slices showed distinct spheres of intense fluorescence and diffuse background fluorescence. Slices labeled with a neuron-specific antibody, neuron-specific enolase, showed staining that correlated with the spheres of intense fluorescence of BCECF-loaded cells. Slices labeled with a glial-specific antibody, glial fibrillary acidic protein, showed a diffuse, background staining. Neurons that were retrograde-labeled with rhodamine beads fluoresced as large spheres that exactly correlated with the fluorescence from BCECF-loaded cells. Further, large fluorescent spheres had membrane potentials of about -60 mV and generated action potentials. These findings indicate that the large fluorescent spheres are neurons. pHi was measured in these large spheres (neurons) in the dorsal and ventral medullary chemosensitive regions, and was 7.32 +/- 0.02 (n = 110) and 7.38 +/- 0.02 (n = 85), respectively.

Nuclear magnetic resonance spectroscopy of seizure states

Magnetic resonance spectroscopy (MRS) can be used for noninvasive measurement of more than two dozen small metabolites in the brains of living animals and humans. In the first decade of its use for study of seizure phenomena in animals, MRS successfully detected in vivo seizure-induced cerebral acidosis and reduction of phosphocreatine concentration, changes that had been described previously by techniques requiring destruction of tissue. Thus validated, MRS was used to reveal new aspects of epileptic pathophysiology in animals: (a) dissociation of brain lactate and pH during experimental status epilepticus of low and intermediate intensity, reflecting metabolic compartmentation; and (b) long persistence of metabolically active elevated brain lactate after brief cortical electroshock. The latter phenomenon may be an extreme form of a mechanism by which lactate production primes synaptic terminals for maximal sustained firing rates during normal brain activation. Diffusion-weighted imaging of rat brain has shown that status epilepticus apparently shortens the mean path length of water diffusion, a novel finding that provides new insight concerning the physical conditions under which the seizure-related chemical changes detected by MRS occur. MRS study of epileptic patients has been undertaken more recently as instruments large enough for observations on humans have become available. Acidosis, reduction of phosphocreatine, and elevation of lactate have all been demonstrated in the human brain during seizure discharge. Chronic reduction of N-acetylaspartate in limbic regions probably reflects neuronal loss and may correlate with mesial temporal sclerosis.