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Tran TT, Wei K, Cole S, Mena E, Csete M, King KS. Brain MR Spectroscopy Markers of Encephalopathy Due to Nonalcoholic Steatohepatitis. J Neuroimaging 2020; 30:697-703. [PMID: 32705733 DOI: 10.1111/jon.12728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/22/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE In hepatic encephalopathy (HE), osmotic stressors promoting brain edema result in a compensatory drop in the astrocyte metabolite myo-inositol (mI). Identifying differences between nonalcoholic steatohepatitis (NASH) with and without HE and healthy controls using proton magnetic resonance spectroscopy (MRS) and evaluating hypoalbuminemia and hyperammonemia as osmotic stressors that predict the reduction of mI allow further understanding of mechanisms that promote brain edema in HE. The aim of this study was to assess brain edema in HE using characteristic MRS markers and serum albumin. METHODS We evaluated between group differences among 19 NASH cirrhosis without HE (Crhs-HE) (age = 63 ± 8.7), 9 NASH cirrhosis with HE (Crhs+HE) (age = 63 ± 9.2), and 16 controls (age = 57.8 ± 11.7) using 1 H MRS. Glutamine (Gln/tCr) and serum albumin were evaluated as predictors of myo-inositol (mI/tCr) using linear regression. Statistical significance was set at P < .05 with adjustment for multiple comparisons. RESULTS Brain mI/tCr was decreased, and Gln/tCr increased in Crhs+HE compared to Crhs-HE and controls in both brain regions (P < .001 for all). Evaluated together as joint predictors, serum albumin but not Gln/tCr significantly predicted mI/tCr in GM (P = .02 and P = .2, respectively) and PWM (P = .01 and P = .1, respectively). CONCLUSION Low mI/tCr and increased Gln/tCr were characteristics of Crhs+HE. Low serum albumin was the strongest predictor of brain osmotic stress indicated by reduced mI/tCr, with no residual independent association seen for brain Gln/tCr concentration. This suggests that hypoalbuminemia in chronic liver disease may promote brain edema in HE.
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Affiliation(s)
| | - Ke Wei
- HMRI Imaging Center, Pasadena, CA
| | | | - Edward Mena
- California Liver Research Institute, Pasadena, CA
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2
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Oriolo G, Egmond E, Mariño Z, Cavero M, Navines R, Zamarrenho L, Solà R, Pujol J, Bargallo N, Forns X, Martin-Santos R. Systematic review with meta-analysis: neuroimaging in hepatitis C chronic infection. Aliment Pharmacol Ther 2018. [PMID: 29536563 DOI: 10.1111/apt.14594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic hepatitis C is considered a systemic disease because of extra-hepatic manifestations. Neuroimaging has been employed in hepatitis C virus-infected patients to find in vivo evidence of central nervous system alterations. AIMS Systematic review and meta-analysis of neuroimaging research in chronic hepatitis C treatment naive patients, or patients previously treated without sustained viral response, to study structural and functional brain impact of hepatitis C. METHODS Using PRISMA guidelines a database search was conducted from inception up until 1 May 2017 for peer-reviewed studies on structural or functional neuroimaging assessment of chronic hepatitis C patients without cirrhosis or encephalopathy, with control group. Meta-analyses were performed when possible. RESULTS The final sample comprised 25 studies (magnetic resonance spectroscopy [N = 12], perfusion weighted imaging [N = 1], positron emission tomography [N = 3], single-photon emission computed tomography [N = 4], functional connectivity in resting state [N = 1], diffusion tensor imaging [N = 2] and structural magnetic resonance imaging [N = 2]). The whole sample was of 509 chronic hepatitis C patients, with an average age of 41.5 years old and mild liver disease. A meta-analysis of magnetic resonance spectroscopy studies showed increased levels of choline/creatine ratio (mean difference [MD] 0.12, 95% confidence interval [CI] 0.06-0.18), creatine (MD 0.85, 95% CI 0.42-1.27) and glutamate plus glutamine (MD 1.67, 95% CI 0.39-2.96) in basal ganglia and increased levels of choline/creatine ratio in centrum semiovale white matter (MD 0.13, 95% CI 0.07-0.19) in chronic hepatitis C patients compared with healthy controls. Photon emission tomography studies meta-analyses did not find significant differences in PK11195 binding potential in cortical and subcortical regions of chronic hepatitis C patients compared with controls. Correlations were observed between various neuroimaging alterations and neurocognitive impairment, fatigue and depressive symptoms in some studies. CONCLUSIONS Patients with chronic hepatitis C exhibit cerebral metabolite alterations and structural or functional neuroimaging abnormalities, which sustain the hypothesis of hepatitis C virus involvement in brain disturbances.
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Affiliation(s)
- G Oriolo
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d'Investigació Biomèdica Arthur Pi I Sunyer (IDIBAPS), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain.,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - E Egmond
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d'Investigació Biomèdica Arthur Pi I Sunyer (IDIBAPS), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain.,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.,Department of Health and Clinical Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Z Mariño
- Liver Unit, Hospital Clinic, IDIBAPS, Centro Investigación Biomédica en Red de Enfermedades hepáticas y digestivas, (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - M Cavero
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d'Investigació Biomèdica Arthur Pi I Sunyer (IDIBAPS), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain.,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - R Navines
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d'Investigació Biomèdica Arthur Pi I Sunyer (IDIBAPS), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain.,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - L Zamarrenho
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
| | - R Solà
- Liver Unit, Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, CIBERSAM, Barcelona, Spain
| | - N Bargallo
- Center of Diagnostic Image (CDIC), Hospital Clinic, Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - X Forns
- Liver Unit, Hospital Clinic, IDIBAPS, Centro Investigación Biomédica en Red de Enfermedades hepáticas y digestivas, (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - R Martin-Santos
- Department of Psychiatry and Psychology, Hospital Clinic, Institut d'Investigació Biomèdica Arthur Pi I Sunyer (IDIBAPS), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Barcelona, Spain.,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain.,Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
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3
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Arm J, Al-iedani O, Quadrelli S, Ribbons K, Lea R, Lechner-Scott J, Ramadan S. Reliability of neurometabolite detection with two-dimensional localized correlation spectroscopy at 3T. J Magn Reson Imaging 2018; 48:1559-1569. [DOI: 10.1002/jmri.26036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/20/2018] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jameen Arm
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
| | - Oun Al-iedani
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
| | - Scott Quadrelli
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Princess Alexandra Hospital; Woolloongabba / University of Queensland, Faculty of Medicine; Brisbane Australia
| | - Karen Ribbons
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Department of Neurology; John Hunter Hospital; Lookout Road, New Lambton Heights NSW Australia
| | - Rod Lea
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- Institute of Health and Biomedical Innovation, School of Biomedical Sciences; Queensland University of Technology; Brisbane Australia
| | - Jeannette Lechner-Scott
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Department of Neurology; John Hunter Hospital; Lookout Road, New Lambton Heights NSW Australia
| | - Saadallah Ramadan
- School of Health Sciences, Faculty of Health and Medicine; University of Newcastle; Callaghan NSW Australia
- Hunter Medical Research Institute; Kookaburra Circuit; New Lambton Heights NSW Australia
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Kumar A, Deep A, Gupta RK, Atam V, Mohindra S. Brain Microstructural Correlates of Cognitive Dysfunction in Clinically and Biochemically Normal Hepatitis C Virus Infection. J Clin Exp Hepatol 2017; 7:198-204. [PMID: 28970706 PMCID: PMC5620352 DOI: 10.1016/j.jceh.2017.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 03/14/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS This study examined correlates of the brain's neurocognitive performance among clinically and biochemically normal adult patient with hepatitis C virus (HCV). We hypothesized that anti-HCV positive individuals would demonstrate structural brain abnormalities and neurocognitive dysfunction as well as the changes in cell component and extracellular space in the white matter regions of brain in asymptomatic HCV infection by using diffusion tensor tractrography (DTT) metrics. METHODS Anti-HCV positive patient (n = 40), and healthy controls (n = 31), fulfilling inclusion criteria (incidentally detected anti-HCV positive) and able to provide informed consent were screened and recruited for the study. All these subjects and controls underwent subjective assessment of their quality of life related symptoms, neuropsychometric tests (NPT) and magnetic resonance imaging. RESULTS The patients were subjected to neuroimaging as well as psychological testing. There was no significant difference in basic laboratory parameters in these two groups. Independent t-test reveals significantly lower neuropsychological functioning as compared to healthy control. A significantly decreased FA values and myoinsitol were observed in HCV subjects on sensory, inferior longitudinal fascicules, and STR fiber bundles as compared to healthy control. Bivariate correlation analysis reveals that neuropsychological scores are significantly positive. CONCLUSION Our result show that HCV positive individuals would demonstrate structural brain abnormalities and neurocognitive dysfunction as well as the changes in cell component and extracellular space in the white matter regions of brain in asymptomatic HCV infection by using DTT metrics.
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Key Words
- BD, block design
- CC, central cortex
- Cho, choline
- DS, digit symbol
- DTT, diffusion tensor tractrography
- FA, fractional anisotrophy
- FCA, figure connection test A
- FCB, figure connection test B
- Gln, glutamine
- Glx, glutamate
- ILF, inferior longitudinal fascicules
- Ins, inositol
- MD, mean diffusivity
- MRI
- NAA, N-acetylaspartate
- OA, object assembly
- PA, picture arrangement
- PC, picture completion
- QOL, quality of life
- SLF, superior longitudinal fascicules
- STR fiber bundles
- STR, superior thalamic radiations
- hepatitis C virus
- myoinsitol
- neuropsychometric tests
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Affiliation(s)
- Ajay Kumar
- Department of Medical Gastroenterology, King George's Medical University, Lucknow 226003, India,Address for correspondence: Ajay Kumar, Assistant Prof, Department of Medical Gastroenterology, K.G. Medical University, Lucknow, UP 226003, India. Tel.: +91 9455519306.Department of Medical Gastroenterology, K.G. Medical UniversityLucknowUP226003India
| | - Amar Deep
- Department of Medical Gastroenterology, King George's Medical University, Lucknow 226003, India,Experimental and Public Health Lab, Department of Zoology, University of Lucknow, 226003, India
| | - Rakesh K. Gupta
- Department of Radiodiagnosis, SGPGIMS, Lucknow 226003, India
| | - Virendra Atam
- Department of Medicine, King George's Medical University, India
| | - Samir Mohindra
- Department of Gastroenterology, SGPGIMS, Lucknow, UP, India
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Echo-Planar J-resolved Spectroscopic Imaging using Dual Read-outs: Implementation and Quantitation of Human Brain Metabolites. Sci Rep 2017; 7:3087. [PMID: 28596547 PMCID: PMC5465060 DOI: 10.1038/s41598-017-03121-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/24/2017] [Indexed: 12/11/2022] Open
Abstract
Attempts have been made to reduce the total scan time in multi-dimensional J-resolved spectroscopic imaging (JRESI) using an echo-planar (EP) readout gradient, but acquisition duration remains a limitation for routine clinical use in the brain. We present here a significant acceleration achieved with a 4D EP-JRESI sequence that collects dual phase encoded lines within a single repetition time (TR) using two bipolar read-out trains. The performance and reliability of this novel 4D sequence, called Multi-Echo based Echo-Planar J-resolved Spectroscopic Imaging (ME-EP-JRESI), was evaluated in 10 healthy controls and a brain phantom using a 3 T MRI/MRS scanner. The prior knowledge fitting (ProFit) algorithm, with a new simulated basis set consisting of macromolecules and lipids apart from metabolites of interest, was used for quantitation. Both phantom and in-vivo data demonstrated that localization and spatial/spectral profiles of metabolites from the ME-EP-JRESI sequence were in good agreement with that of the EP-JRESI sequence. Both in the occipital and temporal lobe, metabolites with higher physiological concentrations including Glx (Glu+Gln), tNAA (NAA+NAAG), mI all had coefficient of variations between 9-25%. In summary, we have implemented, validated and tested the ME-EP-JRESI sequence, demonstrating that multi-echo acquisition can successfully reduce the total scan duration for EP-JRESI sequences.
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Key concepts in MR spectroscopy and practical approaches to gaining biochemical information in children. Pediatr Radiol 2016; 46:941-51. [PMID: 27233787 DOI: 10.1007/s00247-014-3204-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 09/11/2014] [Accepted: 10/01/2014] [Indexed: 10/21/2022]
Abstract
Magnetic resonance spectroscopy (MRS) provides independent biochemical information and has become an invaluable adjunct to MRI and other imaging modalities. This review introduces key concepts and presents basic methodological steps regarding the acquisition and the interpretation of proton MRS. We review major brain metabolites and discuss MRS dependence on age, location, echo time and field strength.
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7
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Martel D, Tse Ve Koon K, Le Fur Y, Ratiney H. Localized 2D COSY sequences: Method and experimental evaluation for a whole metabolite quantification approach. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2015; 260:98-108. [PMID: 26432399 DOI: 10.1016/j.jmr.2015.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 05/08/2023]
Abstract
Two-dimensional spectroscopy offers the possibility to unambiguously distinguish metabolites by spreading out the multiplet structure of J-coupled spin systems into a second dimension. Quantification methods that perform parametric fitting of the 2D MRS signal have recently been proposed for resolved PRESS (JPRESS) but not explicitly for Localized Correlation Spectroscopy (LCOSY). Here, through a whole metabolite quantification approach, correlation spectroscopy quantification performances are studied. The ability to quantify metabolite relaxation constant times is studied for three localized 2D MRS sequences (LCOSY, LCTCOSY and the JPRESS) in vitro on preclinical MR systems. The issues encountered during implementation and quantification strategies are discussed with the help of the Fisher matrix formalism. The described parameterized models enable the computation of the lower bound for error variance--generally known as the Cramér Rao bounds (CRBs), a standard of precision--on the parameters estimated from these 2D MRS signal fittings. LCOSY has a theoretical net signal loss of two per unit of acquisition time compared to JPRESS. A rapid analysis could point that the relative CRBs of LCOSY compared to JPRESS (expressed as a percentage of the concentration values) should be doubled but we show that this is not necessarily true. Finally, the LCOSY quantification procedure has been applied on data acquired in vivo on a mouse brain.
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Affiliation(s)
- Dimitri Martel
- Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Claude Bernard Lyon 1, France
| | - K Tse Ve Koon
- Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Claude Bernard Lyon 1, France
| | - Yann Le Fur
- Aix-Marseille Université, CRMBM, CNRS UMR, 7339 Marseille, France
| | - Hélène Ratiney
- Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Claude Bernard Lyon 1, France.
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Croarkin PE, Thomas MA, Port JD, Baruth JM, Choi DS, Abulseoud OA, Frye MA. N-acetylaspartate normalization in bipolar depression after lamotrigine treatment. Bipolar Disord 2015; 17:450-7. [PMID: 25495884 PMCID: PMC4655601 DOI: 10.1111/bdi.12285] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/10/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of the present study was to examine N-acetylaspartate (NAA), a general marker of neuronal viability, and total NAA (tNAA), the combined signal of NAA and N-acetylaspartylglutamate, in bipolar depression before and after lamotrigine treatment. Given that NAA is synthesized through direct acetylation of aspartate by acetyl-coenzyme A-l-aspartate-N-acetyltransferase, we hypothesized that treatment with lamotrigine would be associated with an increase in NAA level. METHODS Patients with bipolar depression underwent two-dimensional proton magnetic resonance spectroscopy of the anterior cingulate at baseline (n = 15) and after 12 weeks of lamotrigine treatment (n = 10). A group of age-matched healthy controls (n = 9) underwent scanning at baseline for comparison. RESULTS At baseline, patients with bipolar depression had significantly lower NAA [mean standard deviation (SD) = 1.13 (0.21); p = 0.02] than controls [mean (SD) = 1.37 (0.27)]. Significant increases in NAA [mean (SD) = 1.39 (0.21); p = 0.01] and tNAA [mean (SD) = 1.61 (0.25); p = 0.02] levels were found after 12 weeks of lamotrigine treatment. CONCLUSIONS These data suggest an NAA deficit in bipolar depression that is normalized after lamotrigine treatment. Future research is warranted to evaluate whether baseline NAA level is a potential biomarker for identifying lamotrigine response patterns and whether this functional brain change has an associated clinical response.
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Affiliation(s)
- Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - M Albert Thomas
- Department of Radiology, Psychiatry, and Biomedical Engineering, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - John D Port
- Department of Radiology, Mayo Clinic, Rochester, MN
| | | | - Doo-Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | | | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Lin AP, Ramadan S, Stern RA, Box HC, Nowinski CJ, Ross BD, Mountford CE. Changes in the neurochemistry of athletes with repetitive brain trauma: preliminary results using localized correlated spectroscopy. ALZHEIMERS RESEARCH & THERAPY 2015; 7:13. [PMID: 25780390 PMCID: PMC4361214 DOI: 10.1186/s13195-015-0094-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 01/07/2015] [Indexed: 12/14/2022]
Abstract
Introduction The goal was to identify which neurochemicals differ in professional athletes with repetitive brain trauma (RBT) when compared to healthy controls using a relatively new technology, in vivo Localized COrrelated SpectroscopY (L-COSY). Methods To achieve this, L-COSY was used to examine five former professional male athletes with 11 to 28 years of exposure to contact sports. Each athlete who had had multiple symptomatic concussions and repetitive sub concussive trauma during their career was assessed by an experienced neuropsychologist. All athletes had clinical symptoms including headaches, memory loss, confusion, impaired judgment, impulse control problems, aggression, and depression. Five healthy men, age and weight matched to the athlete cohort and with no history of brain trauma, were recruited as controls. Data were collected from the posterior cingulate gyrus using a 3 T clinical magnetic resonance scanner equipped with a 32 channel head coil. Results The variation of the method was calculated by repeated examination of a healthy control and phantom and found to be 10% and 5%, respectively, or less. The L-COSY measured large and statistically significant differences (P ≤0.05), between healthy controls and those athletes with RBT. Men with RBT showed higher levels of glutamine/glutamate (31%), choline (65%), fucosylated molecules (60%) and phenylalanine (46%). The results were evaluated and the sample size of five found to achieve a significance level P = 0.05 and a power of 90%. Differences in N-acetyl aspartate and myo-inositol between RBT and controls were small and were not statistically significance. Conclusions A study of a small cohort of professional athletes, with a history of RBT and symptoms of chronic traumatic encephalopathy when compared with healthy controls using 2D L-COSY, showed elevations in brain glutamate/glutamine and choline as recorded previously for early traumatic brain injury. For the first time increases in phenylalanine and fucose are recorded in the brains of athletes with RBT. Larger studies utilizing the L-COSY method may offer an in-life method of diagnosis and personalized approach for monitoring the acute effects of mild traumatic brain injury and the chronic effects of RBT.
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Affiliation(s)
- Alexander P Lin
- Center for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street HIM-820, Boston, MA 02115 USA
| | - Saadallah Ramadan
- Center for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street HIM-820, Boston, MA 02115 USA ; Centre for MR in Health, School of Health Sciences, University of Newcastle, Newcastle, NSW 2308 Australia
| | - Robert A Stern
- Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA 02118 USA ; BU Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA 02118 USA
| | - Hayden C Box
- Center for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street HIM-820, Boston, MA 02115 USA
| | - Christopher J Nowinski
- Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA 02118 USA ; Sports Legacy Institute, Waltham, MA 02451 USA
| | - Brian D Ross
- Center for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street HIM-820, Boston, MA 02115 USA ; Clinical Spectroscopy, Huntington Medical Research Institutes, Pasadena, CA 91105 USA
| | - Carolyn E Mountford
- Center for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street HIM-820, Boston, MA 02115 USA ; Centre for MR in Health, School of Health Sciences, University of Newcastle, Newcastle, NSW 2308 Australia
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Thames AD, Castellon SA, Singer EJ, Nagarajan R, Sarma MK, Smith J, Thaler NS, Truong JH, Schonfeld D, Thomas MA, Hinkin CH. Neuroimaging abnormalities, neurocognitive function, and fatigue in patients with hepatitis C. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2015; 2:e59. [PMID: 25610883 PMCID: PMC4299885 DOI: 10.1212/nxi.0000000000000059] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/21/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examined neurologic abnormalities (as measured by proton magnetic resonance spectroscopy imaging and diffusion tensor imaging), neurocognitive performance, and fatigue among a sample of adults with hepatitis C virus (HCV). We hypothesized that HCV+ individuals would demonstrate structural brain abnormalities and neurocognitive compromise consistent with frontostriatal dysfunction as well as increased fatigue compared to controls. METHOD Participants were 76 individuals diagnosed with HCV and 20 controls who underwent a comprehensive neurocognitive evaluation and clinical assessments. A subset of the HCV+ participants (n = 29) and all controls underwent MRI. RESULTS Individuals diagnosed with chronic HCV infection demonstrated greater fractional anisotropy in the striatum as well as greater mean diffusivity in the fronto-occiptal fasciculus and external capsule compared to HCV- controls. HCV+ participants also demonstrated lower levels of N-acetylaspartate in bilateral parietal white matter and elevations in myo-inosital (mI) in bilateral frontal white matter compared to HCV- controls (all p values < 0.05). HCV+ participants also demonstrated significantly poorer neuropsychological performance, particularly in processing speed and verbal fluency. HCV+ patients reported higher levels of fatigue than controls, and fatigue was significantly correlated with diffusivity in the superior fronto-occipital fasciculus, elevations in mI in frontal white matter, and overall cognitive performance. CONCLUSIONS Our results suggest that HCV-associated neurologic complications disrupt frontostriatal structures, which may result in increased fatigue and poorer cognitive performance, particularly in those cognitive domains regulated by frontostriatal regions.
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Affiliation(s)
- April D Thames
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Steven A Castellon
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Elyse J Singer
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Rajakumar Nagarajan
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Manoj K Sarma
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Jason Smith
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Nicholas S Thaler
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Jonathan Hien Truong
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Daniel Schonfeld
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - M Albert Thomas
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
| | - Charles H Hinkin
- David Geffen School of Medicine (A.D.T., S.A.C., E.J.S., R.N., M.K.S., N.S.T., M.A.T., C.H.H.), University of California, Los Angeles; Greater Los Angeles VA Healthcare System (S.A.C., J.S., D.S., C.H.H.); and Department of Infectious Disease (J.H.T.), Kaiser Permanente Antelope Valley, Lancaster, CA
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11
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Thomas MA, Nagarajan R, Huda A, Margolis D, Sarma MK, Sheng K, Reiter RE, Raman SS. Multidimensional MR spectroscopic imaging of prostate cancer in vivo. NMR IN BIOMEDICINE 2014; 27:53-66. [PMID: 23904127 DOI: 10.1002/nbm.2991] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/12/2013] [Accepted: 05/21/2013] [Indexed: 06/02/2023]
Abstract
Prostate cancer (PCa) is the second most common type of cancer among men in the United States. A major limitation in the management of PCa is an inability to distinguish, early on, cancers that will progress and become life threatening. One-dimensional (1D) proton ((1)H) MRS of the prostate provides metabolic information such as levels of choline (Ch), creatine (Cr), citrate (Cit), and spermine (Spm) that can be used to detect and diagnose PCa. Ex vivo high-resolution magic angle spinning (HR-MAS) of PCa specimens has revealed detection of more metabolites such as myo-inositol (mI), glutamate (Glu), and glutamine (Gln). Due to the J-modulation and signal overlap, it is difficult to quantitate Spm and other resonances in the prostate clearly by single- and multivoxel-based 1D MR spectroscopy. This limitation can be minimized by adding at least one more spectral dimension by which resonances can be spread apart, thereby increasing the spectral dispersion. However, recording of multivoxel-based two-dimensional (2D) MRS such as J-resolved spectroscopy (JPRESS) and correlated spectroscopy (L-COSY) combined with 2D or three-dimensional (3D) magnetic resonance spectroscopic imaging (MRSI) using conventional phase-encoding can be prohibitively long to be included in a clinical protocol. To reduce the long acquisition time required for spatial encoding, the echo-planar spectroscopic imaging (EPSI) technique has been combined with correlated spectroscopy to give four-dimensional (4D) echo-planar correlated spectroscopic imaging (EP-COSI) as well as J-resolved spectroscopic imaging (EP-JRESI) and the multi-echo (ME) variants. Further acceleration can be achieved using non-uniform undersampling (NUS) and reconstruction using compressed sensing (CS). Earlier versions of 2D MRS, theory of 2D MRS, spectral apodization filters, newer developments and the potential role of multidimensional MRS in PCa detection and management will be reviewed here.
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Affiliation(s)
- M Albert Thomas
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA
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12
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Nagarajan R, Sarma MK, Thomas MA, Chang L, Natha U, Wright M, Hayes J, Nielsen-Saines K, Michalik DE, Deville J, Church JA, Mason K, Critton-Mastandrea T, Nazarian S, Jing J, Keller MA. Neuropsychological function and cerebral metabolites in HIV-infected youth. J Neuroimmune Pharmacol 2012; 7:981-90. [PMID: 23065459 PMCID: PMC3557531 DOI: 10.1007/s11481-012-9407-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 09/18/2012] [Indexed: 12/14/2022]
Abstract
The effects of HIV on brain metabolites and cognitive function are not well understood. Sixteen HIV+youths (15 vertical, 1 transfusion transmissions) receiving combination antiretroviral therapy and 14 age-matched HIV- youths (13-25 years of age) were evaluated with brain two-dimensional (2D) magnetic resonance spectroscopy (MRS) at 3 Tesla (T) and a neuropsychological battery that assessed three cognitive domains (attention/processing speed, psychomotor ability, and executive function). The relationship between brain metabolite ratios and cognitive performance was explored. Compared to HIV- controls, HIV+ subjects had higher sycllo-inositol (Scy)/total creatine (tCr) (+32%, p = 0.016) and higher Scy/total choline (tCho) (+31%, p = 0.018) on 2D-MRS in the right frontal lobe. HIV+ subjects also had higher glutamate (Glu)/tCr (+13%, p = 0.022) and higher Glu/tCho (+15%, p = 0.048) than controls. HIV+ subjects demonstrated poorer attention/processing speed (p = 0.011, d = 1.03) but similar psychomotor and executive function compared to HIV- controls. The attention/processing score also correlated negatively with the ratio of N-acetylaspartate (NAA) to tCr on 2D-MRS (r = -0.75, p = 0.0019) in the HIV- controls, but not in the HIV+ subjects (Fisher's r-z transformation, p < 0.05). Our results suggest that attention/processing speed is impacted by early HIV infection and is associated with right hemisphere NAA/tCr. Scy and Glu ratios are also potential markers of brain health in chronic, lifelong HIV infection in perinatally infected youths receiving antiretroviral therapy.
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Affiliation(s)
- R. Nagarajan
- David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA
| | - M. K. Sarma
- David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA
| | - M. A. Thomas
- David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA
| | - L. Chang
- University of Hawaii, Honolulu, HI, USA
| | - U. Natha
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - M. Wright
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - J. Hayes
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - K. Nielsen-Saines
- David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA
| | - D. E. Michalik
- Miller’s Children’s Hospital of Long Beach, Long Beach, CA, USA
| | - J. Deville
- David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA
| | - J. A. Church
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - K. Mason
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - T. Critton-Mastandrea
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - S. Nazarian
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - J. Jing
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - M. A. Keller
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
- Department of Pediatrics, Harbor-UCLA Medical Center, 1000 West Carson Street, Liu Building, RB3, Box 467, Torrance, CA 90509, USA
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