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Mahmoudi N, Dadak M, Bronzlik P, Maudsley AA, Sheriff S, Lanfermann H, Ding XQ. Microstructural and Metabolic Changes in Normal Aging Human Brain Studied with Combined Whole-Brain MR Spectroscopic Imaging and Quantitative MR Imaging. Clin Neuroradiol 2023; 33:993-1005. [PMID: 37336867 PMCID: PMC10654209 DOI: 10.1007/s00062-023-01300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/27/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aimed to detect age-related brain metabolic and microstructural changes in healthy human brains by the use of whole-brain proton magnetic resonance spectroscopic imaging (1H‑MRSI) and quantitative MR imaging (qMRI). METHODS In this study, 60 healthy participants with evenly distributed ages (between 21 and 69 years) and sex underwent MRI examinations at 3T including whole-brain 1H‑MRSI. The concentrations of the metabolites N‑acetylaspartate (NAA), choline-containing compounds (Cho), total creatine and phosphocreatine (tCr), glutamine and glutamate (Glx), and myo-inositol (mI), as well as the brain relaxation times T2, T2' and T1 were measured in 12 regions of interest (ROI) in each hemisphere. Correlations between measured parameters and age were estimated with linear regression analysis and Pearson's correlation test. RESULTS Significant age-related changes of brain regional metabolite concentrations and tissue relaxation times were found: NAA decreased in eight of twelve ROIs, Cho increased in three ROIs, tCr in four ROIs, and mI in three ROIs. Glx displayed a significant decrease in one ROI and an increase in another ROI. T1 increased in four ROIs and T2 in one ROI, while T2' decreased in two ROIs. A negative correlation of tCr concentrations with T2' relaxation time was found in one ROI as well as the positive correlations of age-related T1 relaxation time with concentrations of tCr, mI, Glx and Cho in another ROI. CONCLUSION Normal aging in human brain is associated with coexistent brain regional metabolic alterations and microstructural changes, which may be related to age-related decline in cognitive, affective and psychomotor domains of life in the older population.
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Affiliation(s)
- N Mahmoudi
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
| | - M Dadak
- Department of Diagnostic and Interventional Radiology and Neuroradiology, St. Vincenz Hospital Paderborn, Paderborn, Germany
| | - P Bronzlik
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - A A Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, FL, USA
| | - S Sheriff
- Department of Radiology, University of Miami School of Medicine, Miami, FL, USA
| | - H Lanfermann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - X-Q Ding
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
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Stampalija T, Ciardo C, Barbieri M, Risso FM, Travan L. Neurodevelopment of infant with late fetal growth restriction. Minerva Obstet Gynecol 2021; 73:482-489. [PMID: 33949822 DOI: 10.23736/s2724-606x.21.04807-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Late fetal growth restriction has increasingly gain interest. Differently from early fetal growth restriction, the severity of this condition and the impact on perinatal mortality and morbidity is less severe. Nevertheless, there is some evidence to suggest that fetuses exposed to growth restriction late in pregnancy are at increased risk of neurological dysfunction and behavioral impairment. The aim of our review was to discuss the available evidence on the neurodevelopmental outcome in fetuses exposed to growth restriction late in pregnancy. Cerebral blood flow redistribution, a Doppler hallmark of late fetal growth restriction, has been associated with this increased risk, although there are still some controversies. Currently, most of the available studies are heterogeneous and do not distinguish between early and late fetal growth restriction when evaluating the long-term outcome, thus, making the correlation between late fetal growth restriction and neurological dysfunction difficult to interpret. The available evidence suggests that fetuses exposed to late growth restriction are at increased risk of neurological dysfunction and behavioral impairment. The presence of the cerebral blood flow redistribution seems to be associated with adverse neurodevelopmental outcome, however, from the present literature the causality cannot be ascertained.
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Affiliation(s)
- Tamara Stampalija
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy - .,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy -
| | - Claudia Ciardo
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Moira Barbieri
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Francesco M Risso
- Division of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Laura Travan
- Division of Neonatology, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Zarinabad N, Abernethy LJ, Avula S, Davies NP, Rodriguez Gutierrez D, Jaspan T, MacPherson L, Mitra D, Rose HEL, Wilson M, Morgan PS, Bailey S, Pizer B, Arvanitis TN, Grundy RG, Auer DP, Peet A. Application of pattern recognition techniques for classification of pediatric brain tumors by in vivo 3T 1 H-MR spectroscopy-A multi-center study. Magn Reson Med 2017; 79:2359-2366. [PMID: 28786132 PMCID: PMC5850456 DOI: 10.1002/mrm.26837] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
Purpose 3T magnetic resonance scanners have boosted clinical application of 1H‐MR spectroscopy (MRS) by offering an improved signal‐to‐noise ratio and increased spectral resolution, thereby identifying more metabolites and extending the range of metabolic information. Spectroscopic data from clinical 1.5T MR scanners has been shown to discriminate between pediatric brain tumors by applying machine learning techniques to further aid diagnosis. The purpose of this multi‐center study was to investigate the discriminative potential of metabolite profiles obtained from 3T scanners in classifying pediatric brain tumors. Methods A total of 41 pediatric patients with brain tumors (17 medulloblastomas, 20 pilocytic astrocytomas, and 4 ependymomas) were scanned across four different hospitals. Raw spectroscopy data were processed using TARQUIN. Borderline synthetic minority oversampling technique was used to correct for the data skewness. Different classifiers were trained using linear discriminative analysis, support vector machine, and random forest techniques. Results Support vector machine had the highest balanced accuracy for discriminating the three tumor types. The balanced accuracy achieved was higher than the balanced accuracy previously reported for similar multi‐center dataset from 1.5T magnets with echo time 20 to 32 ms alone. Conclusion This study showed that 3T MRS can detect key differences in metabolite profiles for the main types of childhood tumors. Magn Reson Med 79:2359–2366, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Niloufar Zarinabad
- Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Laurence J Abernethy
- Department of Radiology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Shivaram Avula
- Department of Radiology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Nigel P Davies
- Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children's Hospital, Birmingham, United Kingdom.,Department of Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Daniel Rodriguez Gutierrez
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom.,Medical Physics, Nottingham University Hospital, Queen's Medical Centre, Nottingham, United Kingdom
| | - Tim Jaspan
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom.,Neuroradiology, Nottingham University Hospital, Queen's Medical Centre, Nottingham, United Kingdom
| | | | - Dipayan Mitra
- Neuroradiology Department, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Heather E L Rose
- Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Martin Wilson
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Paul S Morgan
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom.,Medical Physics, Nottingham University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.,Radiological Sciences, Department of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom
| | - Simon Bailey
- Paediatric Oncology Department, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - Barry Pizer
- Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Theodoros N Arvanitis
- Birmingham Children's Hospital, Birmingham, United Kingdom.,Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
| | - Richard G Grundy
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - Dorothee P Auer
- The Children's Brain Tumour Research Centre, University of Nottingham, Nottingham, United Kingdom.,Neuroradiology, Nottingham University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.,Radiological Sciences, Department of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom
| | - Andrew Peet
- Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children's Hospital, Birmingham, United Kingdom
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Association of brain metabolism with sulcation and corpus callosum development assessed by MRI in late-onset small fetuses. Am J Obstet Gynecol 2015; 212:804.e1-8. [PMID: 25640049 DOI: 10.1016/j.ajog.2015.01.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/12/2014] [Accepted: 01/27/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We sought to determine the relationship between fetal brain metabolism and microstructure expressed by brain sulcation, and corpus callosum (CC) development assessed by fetal brain magnetic resonance (MR) imaging and proton MR spectroscopy ((1)H-MRS). STUDY DESIGN A total of 119 fetuses, 64 that were small for gestational age (estimated fetal weight <10th centile and normal umbilical artery Doppler) and 55 controls underwent a 3T MR imaging/(1)H-MRS exam at 37 weeks. Anatomical T2-weighted images were obtained in the 3 orthogonal planes and long echo time (TE) (1)H-MRS acquired from the frontal lobe. Head biometrics, cortical fissure depths (insula, Sylvian, parietooccipital, cingulate, and calcarine), and CC area and biometries were blindly performed by manual and semiautomated delineation using Analyze software and corrected creating ratios for biparietal diameter and frontooccipital diameter, respectively, for group comparison. Spectroscopic data were processed using LCModel software and analyzed as metabolic ratios of N-acetylaspartate (NAA) to choline (Cho), Cho to creatine (Cr), and myo-inositol (Ino) to Cho. Differences between cases and controls were assessed. To test for the association between metabolic ratios and microstructural parameters, bivariate correlation analyses were performed. RESULTS Spectroscopic findings showed decreased NAA/Cho and increased Cho/Cr ratios in small fetuses. They also presented smaller head biometrics, shorter and smaller CC, and greater insular and cingulate depths. Frontal lobe NAA/Cho significantly correlated with biparietal diameter (r = 0.268; P = .021), head circumference (r = 0.259; P = .026), CC length (r = 0.265; P = .026), CC area (r = 0.317; P = .007), and the area of 6 from the 7 CC subdivisions. It did not correlate with any of the cortical sulcation parameters evaluated. None of the other metabolic ratios presented significant correlations with cortical development or CC parameters. CONCLUSION Frontal lobe NAA/Cho levels-which are considered a surrogate marker of neuronal activity-show a strong association with CC development. These results suggest that both metabolic and callosal alterations may be part of the same process of impaired brain development associated with intrauterine growth restriction.
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Sanz-Cortes M, Simoes RV, Bargallo N, Masoller N, Figueras F, Gratacos E. Proton Magnetic Resonance Spectroscopy Assessment of Fetal Brain Metabolism in Late-Onset ‘Small for Gestational Age' versus ‘Intrauterine Growth Restriction' Fetuses. Fetal Diagn Ther 2014; 37:108-16. [DOI: 10.1159/000365102] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/22/2014] [Indexed: 11/19/2022]
Abstract
Objectives: We used magnetic resonance spectroscopy (MRS) to evaluate brain metabolic differences in small fetuses near term as compared to appropriate for gestational age (AGA) fetuses. Study Design: 71 term small fetuses (estimated fetal weight <10th centile for gestational age with normal umbilical artery Doppler sonography) were subclassified as late intrauterine growth restriction (IUGR) (n = 50) or small for gestational age (SGA) (n = 21), and compared with 65 AGA fetuses. IUGR was defined by either abnormal middle cerebral artery, abnormal uterine artery Doppler sonography or estimated fetal weight <3rd centile. All participants underwent brain magnetic resonance imaging at 37 weeks of gestation, and single-voxel magnetic resonance spectra were obtained from the frontal lobe on a 3-tesla scanner. N-acetylaspartate (NAA)/choline (Cho), NAA/creatine (Cr) and Cho/Cr ratios were calculated and compared between cases and controls. The association of the metabolic ratios with the study groups was tested. Results: After MRS processing and applying quality control criteria, 31 spectra from late-onset IUGR, 11 from SGA and 30 from AGA fetuses were selected for further analysis. Both SGA and late-onset IUGR fetuses showed significantly reduced NAA/Cho levels when compared to AGA fetuses. This decrease followed a linear trend across the three clinical groups that were considered. Conclusions: Both SGA and late-onset IUGR fetuses showed differences in MRS brain metabolic ratios. The findings suggest that despite near-normal perinatal outcomes, SGA fetuses are not constitutionally small and may represent a form of growth disorder that needs to be clarified.
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Chiu PW, Mak HKF, Yau KKW, Chan Q, Chang RCC, Chu LW. Metabolic changes in the anterior and posterior cingulate cortices of the normal aging brain: proton magnetic resonance spectroscopy study at 3 T. AGE (DORDRECHT, NETHERLANDS) 2014; 36:251-64. [PMID: 23709317 PMCID: PMC3889884 DOI: 10.1007/s11357-013-9545-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 05/14/2013] [Indexed: 05/22/2023]
Abstract
Magnetic resonance spectroscopy (MRS) can explore aging at a molecular level. In this study, we investigated the relationships between regional concentrations of metabolites (such as choline, creatine, myo-inositol, and N-acetyl-aspartate) and normal aging in 30 cognitively normal subjects (15 women and 15 men, age range 22-82, mean = 49.9 ± 18.3 years) using quantitative proton magnetic resonance spectroscopy. All MR scans were performed using a 3 T scanner. Point resolved spectroscopy was used as the volume selection method for the region-of-interest and the excitation method for water suppression. Single voxel spectroscopy with short echo time of 39 ms and repetition time of 2,000 ms was employed. Single voxels were placed in the limbic regions, i.e., anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and left and right hippocampi. Cerebrospinal fluid normalization and T1 and T2 correction factors were implemented in the calculation of absolute metabolite concentrations. A standardized T1W 3D volumetric fast field echo and axial T2-weighted fast spin-echo images were also acquired. Our results showed significant positive correlation of choline (r = 0.545, p = 0.002), creatine (r = 0.571, p = 0.001), and N-acetyl-aspartate (r = 0.674, p < 0.001) in the ACC; choline (r = 0.614, p < 0.001), creatine (r = 0.670, p < 0.001), and N-acetyl-aspartate (r = 0.528, p = 0.003) in the PCC; and NAA (r = 0.409, p = 0.025) in the left hippocampus, with age. No significant gender effect on metabolite concentrations was found. In aging, increases in choline and creatine might suggest glial proliferation, and an increase in N-acetyl-aspartate might indicate neuronal hypertrophy. Such findings highlight the metabolic changes of ACC and PCC with age, which could be compensatory to an increased energy demand coupled with a lower cerebral blood flow.
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Affiliation(s)
- Pui-Wai Chiu
- />Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Henry Ka-Fung Mak
- />Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- />Alzheimer’s Disease Research Network, The University of Hong Kong, Hong Kong, China
- />Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- />Queen Mary Hospital, Room 406, Block K, 102 Pokfulam Road, Hong Kong, China
| | - Kelvin Kai-Wing Yau
- />Department of Management Sciences, City University of Hong Kong, Hong Kong, China
| | - Queenie Chan
- />Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- />Philips Healthcare, Hong Kong, China
| | - Raymond Chuen-Chung Chang
- />Laboratory of Neurodegenerative Disease, Department of Anatomy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- />Alzheimer’s Disease Research Network, The University of Hong Kong, Hong Kong, China
- />Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Leung-Wing Chu
- />Division of Geriatric Medicine, Department of Medicine, Queen Mary Hospital, Hong Kong, China
- />Alzheimer’s Disease Research Network, The University of Hong Kong, Hong Kong, China
- />Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Anglin RE, Rosebush PI, Noseworthy MD, Tarnopolsky M, Weber AM, Soreni N, Mazurek MF. Metabolite measurements in the caudate nucleus, anterior cingulate cortex and hippocampus among patients with mitochondrial disorders: a case-control study using proton magnetic resonance spectroscopy. CMAJ Open 2013; 1:E48-55. [PMID: 25077102 PMCID: PMC3985911 DOI: 10.9778/cmajo.20120020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mitochondrial disorders are clinical syndromes associated with mutations in the mitochondrial or nuclear genome that result in impaired oxidative phosphorylation and deficient energy production. Metabolic abnormalities in brain areas associated with cognitive functions could give rise to neuropsychiatric symptomatology. The aim of this study was to use single-voxel proton magnetic resonance spectroscopy to identify metabolic abnormalities in regions implicated in neuropsychiatric symptoms in patients with mitochondrial disorders. METHODS N-acetyl-aspartate and creatine levels were measured in the caudate nucleus, anterior cingulate cortex and hippocampus in 15 patients with mitochondrial disorders compared with 15 healthy controls matched for age and sex. RESULTS N-acetyl-aspartate levels were significantly lower in the caudate nucleus among patients with mitochondrial disorders (mean 7.04 ± 1.19 standard deviation [SD] institutional units) compared with healthy controls (mean 8.19 ± 1.18 SD institutional units; p = 0.02). Creatine levels were lower in the caudate nucleus among patients compared with controls (patients: mean 6.84 ± 1.42 SD institutional units; controls: mean 7.52 ± 0.76 SD institutional units; p = 0.03), but the results were no longer significant after correction for multiple comparisons. There were no significant differences in metabolite measurements between patients and controls in the anterior cingulate cortex and the hippocampus. INTERPRETATION Metabolic abnormalities were identified exclusively in the caudate nucleus, with significantly lower N-acetyl-aspartate levels among patients compared with controls. These results suggest that the corpus striatum may be highly susceptible to mitochondrial oxidative phosphorylation defects and resultant cell loss. Given the role of the caudate nucleus in cognitive and executive functions, our findings raise the possibility that metabolic abnormalities in the caudate nucleus may contribute to cognitive impairment and neuropsychiatric symptoms in patients with mitochondrial disorders, which could be investigated in future studies.
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Affiliation(s)
- Rebecca E Anglin
- Department of Psychiatry and Behavioural Neurosciences and Department of Medicine, McMaster University, Hamilton, Ont
| | - Patricia I Rosebush
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont
| | - Michael D Noseworthy
- McMaster School of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Radiology, McMaster University, Hamilton, Ont
| | | | - Alexander M Weber
- McMaster School of Biomedical Engineering, Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ont
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont
| | - Michael F Mazurek
- Division of Neurology, Department of Medicine, and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont
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Accurate classification of childhood brain tumours by in vivo ¹H MRS - a multi-centre study. Eur J Cancer 2012; 49:658-67. [PMID: 23036849 DOI: 10.1016/j.ejca.2012.09.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/14/2012] [Accepted: 09/07/2012] [Indexed: 11/22/2022]
Abstract
AIMS To evaluate the accuracy of single-voxel Magnetic Resonance Spectroscopy ((1)H MRS) as a non-invasive diagnostic aid for paediatric brain tumours in a multi-national study. Our hypotheses are (1) that automated classification based on (1)H MRS provides an accurate non-invasive diagnosis in multi-centre datasets and (2) using a protocol which increases the metabolite information improves the diagnostic accuracy. METHODS Seventy-eight patients under 16 years old with histologically proven brain tumours from 10 international centres were investigated. Discrimination of 29 medulloblastomas, 11 ependymomas and 38 pilocytic astrocytomas (PILOAs) was evaluated. Single-voxel MRS was undertaken prior to diagnosis (1.5 T Point-Resolved Spectroscopy (PRESS), Proton Brain Exam (PROBE) or Stimulated Echo Acquisition Mode (STEAM), echo time (TE) 20-32 ms and 135-136 ms). MRS data were processed using two strategies, determination of metabolite concentrations using TARQUIN software and automatic feature extraction with Peak Integration (PI). Linear Discriminant Analysis (LDA) was applied to this data to produce diagnostic classifiers. An evaluation of the diagnostic accuracy was performed based on resampling to measure the Balanced Accuracy Rate (BAR). RESULTS The accuracy of the diagnostic classifiers for discriminating the three tumour types was found to be high (BAR 0.98) when a combination of TE was used. The combination of both TEs significantly improved the classification performance (p<0.01, Tukey's test) compared with the use of one TE alone. Other tumour types were classified accurately as glial or primitive neuroectodermal (BAR 1.00). CONCLUSION (1)H MRS has excellent accuracy for the non-invasive diagnosis of common childhood brain tumours particularly if the metabolite information is maximised and should become part of routine clinical assessment for these children.
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Llorente R, Villa P, Marco E, Viveros M. Analyzing the effects of a single episode of neonatal maternal deprivation on metabolite profiles in rat brain: a proton nuclear magnetic resonance spectroscopy study. Neuroscience 2012; 201:12-9. [DOI: 10.1016/j.neuroscience.2011.11.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 10/26/2011] [Accepted: 11/11/2011] [Indexed: 01/01/2023]
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10
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Evaluation of ferritin-overexpressing brain in newly developed transgenic mice. Magn Reson Imaging 2011; 29:179-84. [DOI: 10.1016/j.mri.2010.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/09/2010] [Accepted: 08/27/2010] [Indexed: 11/24/2022]
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van der Voorn JP, Pouwels PJW, Salomons GS, Barkhof F, van der Knaap MS. Unraveling pathology in juvenile Alexander disease: serial quantitative MR imaging and spectroscopy of white matter. Neuroradiology 2009; 51:669-75. [PMID: 19484233 PMCID: PMC2744817 DOI: 10.1007/s00234-009-0540-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 05/18/2009] [Indexed: 11/25/2022]
Abstract
Introduction Alexander disease is a rare disorder of the central nervous system with characteristic symmetric white matter abnormalities with frontal predominance on magnetic resonance (MR) images. Histopathology shows a lack of myelin in the affected white matter, variably interpreted as hypomyelination or demyelination. To increase our insight into the nature of the pathology leading to the MR imaging findings in Alexander disease, we applied serial MR imaging, spectroscopy, magnetization transfer (MT) imaging (MTI), and diffusion tensor imaging (DTI) in six patients with juvenile Alexander disease. Methods The MR imaging protocol comprised T1- and T2-weighted spin echo images and fluid-attenuated inversion recovery images. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and MT ratio (MTR) maps were generated, and MR spectroscopy concentrations were quantified for several metabolites. Results MR imaging showed similar cerebral white matter abnormalities in all patients, with only minor increase on prolonged follow-up, despite sometimes serious clinical progression. MR spectroscopy showed highly elevated levels of myo-inositol, lactate, and choline-containing compounds and decreased total N-acetyl-aspartate and N-acetyl-aspartyl-glutamate levels in the abnormal white matter. High values of ADC were observed, and both FA and MTR were attenuated. Conclusion The sequential MR imaging findings in Alexander disease provide strong evidence against active demyelination as sole explanation for the underlying pathology. An alternative explanation for our spectroscopic, DTI, and MTI findings—which would suggest demyelination—could be hyperplasia and hypertrophy of astrocytes, as seen in low grade gliomas.
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Affiliation(s)
- J Patrick van der Voorn
- Department of Child Neurology, VU University Medical Center, De Boelelaan 1117, 1007 MB, Amsterdam, The Netherlands.
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Barger AV, Campeau NG, Port JD, Renaud DL. MRS is the test of choice for detecting and monitoring disorders of creatine metabolism. Pediatr Neurol 2009; 40:408-10. [PMID: 19380084 DOI: 10.1016/j.pediatrneurol.2008.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 11/04/2008] [Accepted: 12/16/2008] [Indexed: 11/18/2022]
Affiliation(s)
- Andrew V Barger
- Department of Radiology, Mayo Clinic Foundation, Rochester, Minnesota 55905, USA
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Proton magnetic resonance spectroscopy in Kennedy disease. J Neurol Sci 2009; 277:71-5. [DOI: 10.1016/j.jns.2008.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 08/29/2008] [Accepted: 10/15/2008] [Indexed: 01/18/2023]
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Weghuber D, Mandl M, Krssák M, Roden M, Nowotny P, Brehm A, Krebs M, Widhalm K, Bischof MG. Characterization of hepatic and brain metabolism in young adults with glycogen storage disease type 1: a magnetic resonance spectroscopy study. Am J Physiol Endocrinol Metab 2007; 293:E1378-84. [PMID: 17785500 DOI: 10.1152/ajpendo.00658.2006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In glycogen storage disease type 1 (GSD1), children present with severe hypoglycemia, whereas the propensity for hypoglycemia may decrease with age in these patients. It was the aim of this study to elucidate the mechanisms for milder hypoglycemia symptoms in young adult GSD1 patients. Four patients with GSD1 [body mass index (BMI) 23.2 +/- 6.3 kg/m, age 21.3 +/- 2.9 yr] and four healthy controls matched for BMI (23.1 +/- 3.0 kg/m) and age (24.0 +/- 3.1 yr) were studied. Combined (1)H/(31)P nuclear magnetic resonance spectroscopy (NMRS) was used to assess brain metabolism. Before and after administration of 1 mg glucagon, endogenous glucose production (EGP) was measured with d-[6,6-(2)H(2)]glucose and hepatic glucose metabolism was examined by (1)H/(13)C/(31)P NMRS. At baseline, GSD1 patients exhibited significantly lower rates of EGP (0.53 +/- 0.04 vs. 1.74 +/- 0.03 mg.kg(-1).min(-1); P < 0.01) but an increased intrahepatic glycogen (502 +/- 89 vs. 236 +/- 11 mmol/l; P = 0.05) and lipid content (16.3 +/- 1.1 vs. 1.4 +/- 0.4%; P < 0.001). After glucagon challenge, EGP did not change in GSD1 patients (0.53 +/- 0.04 vs. 0.59 +/- 0.24 mg.kg(-1).min(-1); P = not significant) but increased in healthy controls (1.74 +/- 0.03 vs. 3.95 +/- 1.34; P < 0.0001). In GSD1 patients, we found an exaggerated increase of intrahepatic phosphomonoesters (0.23 +/- 0.08 vs. 0.86 +/- 0.19 arbitrary units; P < 0.001), whereas inorganic phosphate decreased (0.36 +/- 0.08 vs. -0.43 +/- 0.17 arbitrary units; P < 0.01). Intracerebral ratios of glucose and lactate to creatine were higher in GSD1 patients (P < 0.05 vs. control). Therefore, hepatic defects of glucose metabolism persist in young adult GSD1 patients. Upregulation of the glucose and lactate transport at the blood-brain barrier could be responsible for the amelioration of hypoglycemic symptoms.
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Affiliation(s)
- D Weghuber
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
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15
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Maeno M, Ishida T, Ishihara S, Sawada K, Kawasaki A, Yanasima R, Koinuma T, Magatani K, Yanasima K. [Time-dependence evaluation of the primary visual cortex by 1H MR-spectroscopy using a stimulation control system]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2007; 63:305-11. [PMID: 17409621 DOI: 10.6009/jjrt.63.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED Proton magnetic resonance spectroscopy ((1)H MRS) is used to evaluate tumors and their remaining function under the assumption that event-related inspection and a method of data collection dependent on time are difficult. Therefore, this study examined the possibility that time depended on in MRS with a visual cortex. We conducted experiments using the following stimulations: REST: eyes are in a closed state, CONTROL eyes are in an open state, and Continuous: consecutive stimulation and time dependence in the visual cortex. We enabled dependence in time by collecting data with a system that controlled stimulation and experimented on stimulation for a short time using this system. The results showed that no significant difference in metabolites was seen in the REST, CONTROL, and Consecutive stimulations. However, a significant difference was seen in Cr and NAA with time-dependent stimulation. Therefore, we considered functional magnetic resonance spectroscopy (fMRS) useful because time-dependent stimulation showed a meaningful difference with REST.
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Affiliation(s)
- Masato Maeno
- Medical Imaging Center, National Rehabilitation Center for Persons With Disabilities
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16
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Marco EM, Adriani W, Canese R, Podo F, Viveros MP, Laviola G. Enhancement of endocannabinoid signalling during adolescence: Modulation of impulsivity and long-term consequences on metabolic brain parameters in early maternally deprived rats. Pharmacol Biochem Behav 2007; 86:334-45. [PMID: 17101171 DOI: 10.1016/j.pbb.2006.10.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Revised: 10/03/2006] [Accepted: 10/04/2006] [Indexed: 10/23/2022]
Abstract
Pharmacological modulation of the endocannabinoid system is a novel but poorly explored field for potential therapy. Early maternal deprivation represents an animal model for specific aspects of neuropsychiatric disorders. This study explored whether a pharmacological manipulation of the endocannabinoid system at adolescence may restore altered phenotypes resulting from early maternal deprivation. Wistar male rats, maternally deprived for 24 h on postnatal day (PND) 9, were administered the fatty-acid amide hydrolase (FAAH) inhibitor URB597 (0, 0.1 or 0.5 mg/kg/day) for six days during adolescence (PND 31-43), while tested in the intolerance-to-delay task. Deprived (DEP) adolescent rats showed a trend for higher impulsivity levels and an increased locomotor response to novelty when compared to non-deprived (NDEP) controls. The low dose of URB597 effectively decreased impulsive behaviour specifically in DEP subjects. Moreover, long-term metabolic brain changes, induced by drug treatment during adolescence, were detected in DEP animals using proton magnetic resonance spectroscopy ((1)H MRS). Significant changes were only found within the hippocampus: N-acetyl-aspartate and total creatine were up-regulated by the low dose; glutamate and glutamate plus glutamine were conversely down-regulated by the higher dose. In summary, administration of URB597 during adolescence increased self-control behaviour and produced enduring brain biochemical modifications, in a model for neuropsychiatric disorders.
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Affiliation(s)
- Eva María Marco
- Unit of Behavioural Neurosciences, Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Roma, Italy
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17
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Alger JR. Assessment of Neurobiological Diseases with Magnetic Resonance Spectroscopy. Neurobiol Dis 2007. [DOI: 10.1016/b978-012088592-3/50074-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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18
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Alix JJP. Recent biochemical advances in white matter ischaemia. Eur Neurol 2006; 56:74-7. [PMID: 16946618 DOI: 10.1159/000095543] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 07/12/2006] [Indexed: 01/17/2023]
Abstract
Stroke is one of the leading causes of death and disability in the developed world and as a result is the focus of intensive research. Historically, investigators in the field have focused on the effects of energy deprivation on the neuronal population, but, in recent times, as imaging techniques have become more advanced, a greater appreciation of the extent of non-neuronal injury has emerged. Initial investigations into the pathophysiology of white matter ischaemia reported damage to central myelinated axons via reversal of the Na+-Ca2+ exchange protein due to Na+ loading and ischaemia-induced membrane depolarisation. The latter also gates voltage-sensitive Ca2+ channels that contribute to the Ca2+ overload both directly and indirectly via Ca2+ release from intracellular stores. Excitotoxicity, once thought the unfortunate preserve of neurons, also contributes to white matter damage via both N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors. However, important physiological differences are apparent in these receptors when compared to those present at the synapse, leading researchers to ask whether the molecular diversity of glutamate receptors will provide successful therapeutic interventions in the future. This brief review aims to summarise recent progress in the field of white matter ischaemia.
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Bathen TF, Sjöbakk TE, Skranes J, Brubakk AM, Vik T, Martinussen M, Myhr GE, Gribbestad IS, Axelson D. Cerebral metabolite differences in adolescents with low birth weight: assessment with in vivo proton MR spectroscopy. Pediatr Radiol 2006; 36:802-9. [PMID: 16703344 DOI: 10.1007/s00247-006-0159-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Revised: 02/01/2006] [Accepted: 03/06/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Children with very low birth weight (VLBW) have a significantly increased risk of later neurodevelopmental problems, while infants born small for gestational age (SGA) at term are also at some risk of developing neurological impairment. OBJECTIVE To investigate possible brain metabolite differences in adolescents with VLBW, SGA at term and controls by proton in vivo magnetic resonance spectroscopy (MRS) at 1.5 T. MATERIALS AND METHODS MR spectra were acquired from volumes localized in the left frontal lobe, containing mainly white matter (54 subjects). Peak areas of N-acetyl aspartate (NAA), choline (Cho) and creatine (Cr) were determined, and the peak area ratio of NAA to Cr, total Cho to Cr, or NAA to Cho calculated. Probabilistic neural network (PNN) analysis was performed utilizing the chemical shift region containing resonances from NAA, Cho and Cr as inputs. RESULTS No significant difference in the peak area ratios could be found using the Kruskal-Wallis test. By application of PNN, a correct classification of 52 of the 54 adolescents with a sensitivity and specificity exceeding 93% for all groups was achieved. CONCLUSION Small, yet systematic, differences in brain metabolite distribution among the groups were confirmed by PNN analysis.
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Affiliation(s)
- Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, and St. Olavs Hospital, Trondheim, Norway.
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Koga K, Mori A, Ohashi S, Kurihara N, Kitagawa H, Ishikawa M, Mitsumoto Y, Nakai M. H MRS identifies lactate rise in the striatum of MPTP-treated C57BL/6 mice. Eur J Neurosci 2006; 23:1077-81. [PMID: 16519673 DOI: 10.1111/j.1460-9568.2006.04610.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mitochondrial dysfunction has been implicated in the death of nigrostriatal dopaminergic neurons in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated experimental models of Parkinson's disease (PD). Here we utilized proton magnetic resonance spectroscopy ((1)H MRS) to identify changes in energy metabolism in the striatum of MPTP-treated C57BL/6 mice. Remarkable increases in lactate/creatine (Lac/Cr) ratio were observed at 2 h and then quickly returned to about the basal level by 7 h after injection of MPTP. Neurochemical and Western blot analyses revealed that dopamine contents and protein levels of tyrosine hydroxylase and dopamine transporter in the striatum were profoundly decreased at 3 days after MPTP treatment. Pretreatment with deprenyl, a monoamine oxidase B inhibitor, or GBR-12909, a dopamine uptake inhibitor, almost completely attenuated both the increases in striatal Lac/Cr ratio and the subsequent loss of dopaminergic nerve terminals in MPTP-treated mice. The present study indicates that (1)H MRS is a sensitive measure of biochemical alterations of the brain in a mouse model of PD, and further shows that the increases in striatal Lac/Cr ratio induced by MPTP may be associated with mitochondrial energy crisis, followed by dopaminergic neurotoxicity.
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Affiliation(s)
- Keiko Koga
- Laboratory of Bioenergetics Research, Tokushima Research Institute, Otsuka Pharmaceutical Co. Ltd, Tokushima 771-0192, Japan
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Bischof MG, Brehm A, Bernroider E, Krssák M, Mlynárik V, Krebs M, Roden M. Cerebral glutamate metabolism during hypoglycaemia in healthy and type 1 diabetic humans. Eur J Clin Invest 2006; 36:164-9. [PMID: 16506960 DOI: 10.1111/j.1365-2362.2006.01615.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The mechanisms responsible for the progressive failure of hypoglycaemia counterregulation in long-standing type 1 diabetes are poorly understood. Increased brain glucose uptake during hypoglycaemia or alterations of brain energy metabolism could effect glucose sensing by the brain and thus contribute to hypoglycaemia-associated autonomic failure. MATERIALS AND METHODS Type 1 diabetic patients (T1DM) and healthy volunteers (CON) were studied before, during and after a hypoglycaemic (50 mg dL(-1)) hyperinsulinaemic (1.5 mU kg(-1) min(-1)) clamp test. The (1)H magnetic resonance spectroscopy of the occipital lobe of the brain was performed employing the STEAM localization technique. The water signal was suppressed by the modified SWAMP method. All spectra were acquired on a 3 Tesla scanner (80 cm MEDSPEC-DBX, Bruker Medical, Ettlingen, Germany) using a 10-cm diameter surface coil. RESULTS During hypoglycaemia, T1DM showed blunted endocrine counterregulation. At baseline the brain tissue glucose : creatine ratio was lower in CON than in T1DM (CON 0.13 +/- 0.05 vs. T1DM 0.19 0.11; P < 0.01). During hypoglycaemia glucose : creatine ratios decreased in both groups (CON 0.07 +/- 0.08, P < 0.05; T1DM 0.03 +/- 0.03, P < 0.001). A significant drop in the glutamate : creatine ratio could only be found in CON during hypoglycaemia (CON 1.36 +/- 0.08 vs. 1.26 +/- 0.11; P < 0.01; T1DM 1.32 +/- 0.13 vs. 1.28 +/- 0.15; P = NS). The ratios of glutamine, N-acetylaspartate, choline and myo-inositol : creatine were not different between both groups and did not change throughout the experiment. CONCLUSIONS Only in CON does moderate hypoglycaemia reduce intracerebral glutamate concentrations, possibly owing to a slower substrate flux through the tricarboxylic acid cycle in neurones. The maintenance of normal energy metabolism in T1DM during hypoglycaemia might effect glucose sensing in the brain and contribute to hypoglycaemia-associated autonomic failure.
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Affiliation(s)
- M G Bischof
- Department of Internal Medicine III, Division of Endocrinology and Metabolism,Medical University of Vienna, Hanusch Hospital, A-1090 Vienna, Austria.
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