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Hasseldam H, Rasmussen RS, El Ali HH, Johansen FF. N-acetyl aspartate levels early after ischemic stroke accurately reflect long-term brain damage. Heliyon 2024; 10:e24233. [PMID: 38293500 PMCID: PMC10825333 DOI: 10.1016/j.heliyon.2024.e24233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/24/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Background Estimation of brain damage following an ischemic stroke is most often performed within the first few days after the insult, where large amounts of oedematous fluid have accumulated. This can potentially hamper correct measurement of infarcted area, since oedema formation poorly reflects infarct size. This study presents a non-invasive, easily applicable and reliable method to accurately predict long-term evolution and late-stage infarction. Objective We performed a longitudinal analysis of brain infarct evolution after MCAO in mice, in order to determine whether water-compensated N-Acetylaspartate (NAA) levels in the infarct area, measured 24 h after the insult, is a suitable marker for late-stage infarction and thereby prognosis. Methods Twenty mice were divided into 4 groups and scanned longitudinally at different time-points after MCAO, followed by euthanisation for histology: Group 1) MRI/MRS at day 1 after MCAO (n = 4), Group 2) MRI/MRS at days 1 and 7 after MCAO (n = 5), Group 3) MRI/MRS at days 1, 7, and 14 after MCAO (n = 3), and Group 4) MRI/MRS at days 1, 7, 14, and 28 after MCAO (n = 4). At days 1, 7, 14, and 28, NAA levels were correlated with histological determination of neuronal death based on Nissl and H&E stainings. Results Twenty-four hours after the insult, NAA levels in the infarcted area decreased by 35 %, but steadily returned to normal after 28 days. In the acute phases, NAA levels strongly correlated with loss of Nissl substance (r2 = -0.874, p = 0.002), whereas NAA levels in later stages reflect glial metabolism and tissue reorganisation. Most importantly, NAA levels 24 h after MCAO was highly correlated with late stage infarction at days 14 and 28 (r2 = 0.73, p = 0.01), in contrast to T2 (r2 = 0.06, p = 0.59). Conclusions By using a fixed voxel, which is easily positioned in the affected area, it is possible to obtain reliable measures of the extent of neuronal loss at early time points independent of oedema and brain deformation. Importantly, NAA levels 24 h after MCAO accurately reflects late-stage infarction, suggesting that NAA is a useful prognostic biomarker early after an ischemic stroke.
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Affiliation(s)
| | | | - Henrik Hussein El Ali
- University of Copenhagen, Department of Biomedical Sciences, 2200 Copenhagen, Denmark
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Zhu SY, Ge W, Zhang H. Diagnostic and prognostic implications of non-high-density lipoprotein cholesterol and homocysteine levels for cognitive impairment in thalamic infarction. World J Psychiatry 2023; 13:985-994. [PMID: 38186727 PMCID: PMC10768482 DOI: 10.5498/wjp.v13.i12.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/06/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Patients with thalamic infarction experience abnormal blockages of multinucleated vessels, affecting the body and thereby the thalamus. Most patients with thalamic infarction have an adverse prognosis, which seriously affects their safety. Therefore, it is essential to analyze the independent risk factors that influence the prognosis of patients with thalamic infarction and develop corresponding preventive measures. AIM To explore the effect of non-high-density lipoprotein cholesterol (non-HDL-C) and Homocysteine (Hcy) levels in cognitive impairment in thalamic infarction. METHODS From March 2019 to March 2022, 80 patients with thalamic infarction were divided into a group with cognitive impairment [Montreal Cognitive Assessment (MoCA) score < 26; 35 patients] and a group with normal cognitive function (MoCA score of 26-30; 45 patients) according to the MoCA score. In addition, 50 healthy people in the same period were selected as the control group. A correlation between the non-HDL-C and Hcy levels and the MoCA score and receiver operating characteristic curve was observed, and the serum non-HDL-C and Hcy levels were analyzed for the diagnosis of cognitive impairment in patients with thalamic infarction. According to the Modified Rankin Scale (MRS) score, 80 patients with thalamic infarction were divided into a good prognosis group (MRS score ≤ 2) and a poor prognosis group (MRS score >2). RESULTS The non-HDL-C and Hcy levels were significantly higher in the group with cognitive impairment than in the group with normal cognitive function (P < 0.05). There was no significant difference in the non-HDL-C level between the control group and the group with normal cognitive function (P > 0.05). The MoCA scores of the group with cognitive impairment were significantly lower than those of the group with normal cognitive function and the control group (P < 0.05). There was a significant difference between the control group and the group with normal cognitive function (P < 0.05). The non-HDL-C and Hcy levels were correlated with the MoCA score (P < 0.05), cognitive impairment [areas under the curve (AUC) = 0.709, 95% confidence interval (95%CI): 0.599-0.816], the non-HDL-C level, and could predict cognitive impairment in patients with thalamic infarction (AUC = 0.738, 95%CI: 0.618-0.859). Hcy combined with non-HDL-C levels can predict cognitive impairment in patients with thalamic infarction (AUC = 0.769, 95%CI: 0.721-0.895).There were 50 patients in the good prognosis group and 30 patients in the poor prognosis group. Compared with the good prognosis group, in the poor prognosis group, the National Institutes of Health Stroke Scale (NIHSS) score, non-HDL-C level, Hcy level, large-area cerebral infarction, atrial fibrillation, and activated partial prothrombin time were statistically significant (P < 0.05). The non-HDL-C level, the Hcy level, the NIHSS score, extensive cerebral serum, and atrial fibrillation may all be independent risk factors for poor prognosis in patients with thalamic infarction (P < 0.05). CONCLUSION Non-HDL-C and Hcy levels are positively correlated with cognitive impairment in patients with thalamic infarction. Non-HDL-C and Hcy levels can be used in the diagnosis of cognitive impairment in patients with thalamic infarction, and the combined detection effect is better. The main factors affecting the prognosis of patients with thalamic infarction are the non-HDL-C level, the Hcy level, the NIHSS score, large-area cerebral infarction, and atrial fibrillation. Clinically, corresponding preventive measures can be formulated based on the above factors to prevent poor prognosis and reduce mortality.
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Affiliation(s)
- Shan-Yao Zhu
- Department of Internal Medicine-Neurology, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Wei Ge
- Department of Internal Medicine-Neurology, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Huan Zhang
- Department of Internal Medicine-Neurology, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 238000, Anhui Province, China
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Helsper S, Yuan X, Bagdasarian FA, Athey J, Li Y, Borlongan CV, Grant SC. Multinuclear MRI Reveals Early Efficacy of Stem Cell Therapy in Stroke. Transl Stroke Res 2023; 14:545-561. [PMID: 35900719 PMCID: PMC10733402 DOI: 10.1007/s12975-022-01057-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/28/2022] [Accepted: 06/16/2022] [Indexed: 10/16/2022]
Abstract
Compromised adult human mesenchymal stem cells (hMSC) can impair cell therapy efficacy and further reverse ischemic recovery. However, in vitro assays require extended passage to characterize cells, limiting rapid assessment for therapeutic potency. Multinuclear magnetic resonance imaging and spectroscopy (MRI/S) provides near real-time feedback on disease progression and tissue recovery. Applied to ischemic stroke, 23Na MRI evaluates treatment efficacy within 24 h after middle cerebral artery occlusion, showing recovery of sodium homeostasis and lesion reduction in specimens treated with hMSC while 1H MRS identifies reduction in lactate levels. This combined metric was confirmed by evaluating treatment groups receiving healthy or compromised hMSC versus vehicle (sham saline injection) over 21 days. Behavioral tests to assess functional recovery and cell analysis for immunomodulatory and macrophage activity to detect hMSC potency confirm MR findings. Clinically, these MR metrics may prove critical to early evaluations of therapeutic efficacy and overall stroke recovery.
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Affiliation(s)
- Shannon Helsper
- The National High Magnetic Field Laboratory, Florida State University, 1800 E. Paul Dirac Dr, Tallahassee, FL, 32310, USA
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA
| | - Xuegang Yuan
- The National High Magnetic Field Laboratory, Florida State University, 1800 E. Paul Dirac Dr, Tallahassee, FL, 32310, USA
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA
| | - F Andrew Bagdasarian
- The National High Magnetic Field Laboratory, Florida State University, 1800 E. Paul Dirac Dr, Tallahassee, FL, 32310, USA
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA
| | - Jacob Athey
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA
| | - Yan Li
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA
| | - Cesario V Borlongan
- Center of Excellence for Aging & Brain Repair, University of South Florida, Tampa, FL, 33612, USA
| | - Samuel C Grant
- The National High Magnetic Field Laboratory, Florida State University, 1800 E. Paul Dirac Dr, Tallahassee, FL, 32310, USA.
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, 32310, USA.
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Patzwaldt K, Berezhnoy G, Ionescu T, Schramm L, Wang Y, Owczorz M, Calderón E, Poli S, Serna Higuita LM, Gonzalez-Menendez I, Quintanilla-Martinez L, Herfert K, Pichler B, Trautwein C, Castaneda-Vega S. Repurposing the mucolytic agent ambroxol for treatment of sub-acute and chronic ischaemic stroke. Brain Commun 2023; 5:fcad099. [PMID: 37065090 PMCID: PMC10090797 DOI: 10.1093/braincomms/fcad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 01/31/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Ambroxol is a well-known mucolytic expectorant, which has gained much attention in amyotrophic lateral sclerosis, Parkinson's and Gaucher's disease. A specific focus has been placed on ambroxol's glucocerebrosidase-stimulating activity, on grounds that the point mutation of the gba1 gene, which codes for this enzyme, is a risk factor for developing Parkinson's disease. However, ambroxol has been attributed other characteristics, such as the potent inhibition of sodium channels, modification of calcium homeostasis, anti-inflammatory effects and modifications of oxygen radical scavengers. We hypothesized that ambroxol could have a direct impact on neuronal rescue if administered directly after ischaemic stroke induction. We longitudinally evaluated 53 rats using magnetic resonance imaging to examine stroke volume, oedema, white matter integrity, resting state functional MRI and behaviour for 1 month after ischemic stroke onset. For closer mechanistic insights, we evaluated tissue metabolomics of different brain regions in a subgroup of animals using ex vivo nuclear magnetic resonance spectroscopy. Ambroxol-treated animals presented reduced stroke volumes, reduced cytotoxic oedema, reduced white matter degeneration, reduced necrosis, improved behavioural outcomes and complex changes in functional brain connectivity. Nuclear magnetic resonance spectroscopy tissue metabolomic data at 24 h post-stroke proposes several metabolites that are capable of minimizing post-ischaemic damage and that presented prominent shifts during ambroxol treatment in comparison to controls. Taking everything together, we propose that ambroxol catalyzes recovery in energy metabolism, cellular homeostasis, membrane repair mechanisms and redox balance. One week of ambroxol administration following stroke onset reduced ischaemic stroke severity and improved functional outcome in the subacute phase followed by reduced necrosis in the chronic stroke phase.
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Affiliation(s)
- Kristin Patzwaldt
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Georgy Berezhnoy
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Tudor Ionescu
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Linda Schramm
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Yi Wang
- Hertie Institute for Clinical Brain Research, Department for Neurology, University Hospital Tuebingen, Tuebingen 72076, Germany
| | - Miriam Owczorz
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Eduardo Calderón
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen 72076, Germany
| | - Sven Poli
- Hertie Institute for Clinical Brain Research, Department for Neurology, University Hospital Tuebingen, Tuebingen 72076, Germany
| | - Lina M Serna Higuita
- Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital Tuebingen, Tuebingen 72076, Germany
| | - Irene Gonzalez-Menendez
- Institute of Pathology and Neuropathology, Comprehensive Cancer Center, Eberhard Karls University, Tuebingen 72076, Germany
- Cluster of Excellence iFIT (EXC 2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Comprehensive Cancer Center, Eberhard Karls University, Tuebingen 72076, Germany
- Cluster of Excellence iFIT (EXC 2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Kristina Herfert
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Bernd Pichler
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
- Cluster of Excellence iFIT (EXC 2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Christoph Trautwein
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
| | - Salvador Castaneda-Vega
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tuebingen, Tuebingen 72076, Germany
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen 72076, Germany
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Lin X, Wang W, Tao T, Zhang D, Mao L, He X. Synthetic role of miR-411-5p and CT perfusion information in predicting clinical outcomes after thrombolysis in acute cerebral infarction. Acta Neurol Belg 2022; 123:457-464. [PMID: 35933505 DOI: 10.1007/s13760-022-02041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/15/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Our aim was to investigate the predictive value of microRNA (miR)-411-5p and computed tomography perfusion (CTP) parameters on the prognosis of acute cerebral infarction (ACI) patients receiving intravenous thrombolysis based on analyzing the expression changes of miR-411-5p before and after thrombolytic therapy. METHODS Serum miR-411-5p expression in 96 patients with ACI was measured using quantitative real-time PCR. To evaluate prognosis, we measured National Institutes of Health Stroke Scale (NIHSS) scores before and 24 h after thrombolytic therapy in ACI patients and the modified Rankin scale (mRS) score at 3 months (90 days) after ACI onset. Influence factors analysis to predict the prognosis of patients who received thrombolytic therapy was performed by logistic regression analysis. Receiver operating characteristic analysis was used to evaluate the predictive accuracy and thresholds of factors associated with thrombolytic prognosis. RESULTS Serum miR-411-5p at 24 h after thrombolysis and at 3 months after onset in ACI patients was upregulated. Additionally, the correlation of miR-411-5p with NIHSS score and CTP parameters were found. Moreover, miR-411-5p and two CTP parameters [cerebral blood flow (CBF) and cerebral blood volume (CBV)] were identified as independent predictors of short- and long-term prognosis following thrombolysis in ACI patients. Furthermore, miR-411-5p, CBF and CBV had high predictive accuracy for patient prognosis, and their combination had the best accuracy. CONCLUSION miR-411-5p is increased by thrombolytic therapy in ACI patients, and miR-411-5p, CBF and CBV may serve as independent biomarkers for predicting short- and long-term prognosis following intravenous thrombolysis in ACI patients.
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Affiliation(s)
- Xia Lin
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China.
| | - Wenjie Wang
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China
| | - Taotao Tao
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China
| | - Danhong Zhang
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China
| | - Lingqun Mao
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China
| | - Xinwei He
- Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), No. 999, Donghai Avenue, economic development zone, Taizhou, 318000, Zhejiang, China
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Ostojic SM, Engeset D. Improving Brain Creatine Uptake by Klotho Protein Stimulation: Can Diet Hit the Big Time? Front Nutr 2022; 8:795599. [PMID: 35004821 PMCID: PMC8732999 DOI: 10.3389/fnut.2021.795599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sergej M Ostojic
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Dagrun Engeset
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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Frittoli RB, Pereira DR, Lapa AT, Postal M, Sinicato NA, Fernandes PT, Cendes F, Castellano G, Rittner L, Marini R, Niewold TB, Appenzeller S. Axonal dysfunction is associated with interferon-γ levels in childhood-onset systemic lupus erythematosus: a multivoxel magnetic resonance spectroscopy study. Rheumatology (Oxford) 2021; 61:1529-1537. [PMID: 34282445 DOI: 10.1093/rheumatology/keab530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Axonal/neuronal damage has been shown to be a pathological finding that precedes neuropsychiatric manifestations in systemic lupus erythematosus (SLE). Therefore, the objective of this study was to determine the presence of axonal dysfunction in childhood-onset SLE patients (cSLE) and to determine clinical, immunological, and treatment features associated with its occurrence. METHODS We included 86 consecutive cSLE patients [median age 17 years (range 5-28)] and 71 controls [median age 18 years (5-28)]. We performed Proton Magnetic Resonance Spectroscopic Imaging (1H-MRSI) using point resolved spectroscopy sequence (PRESS) over the superior-posterior region of the corpus callosum and signals from N-acetylaspartate compounds (NAA), choline-based compounds (CHO); creatine containing compounds (Cr), myo-inositol (mI), lactate (Lac), glutamate (Glu), glutamine (Gln) and lactate (Lac) were measured and metabolites/Cr ratios were determined. Complete clinical, laboratory and neurological evaluations were performed in all subjects. Sera IL-4, IL-5, IL-6, IL-10, IL-12, IL-17, TNF- α, INF- γ cytokines levels, antiribosomal P protein antibodies (anti-P) and S100β were measured by enzyme-linked immunosorbent assay (ELISA) using commercial kits. Data were compared by non-parametric tests. RESULTS NAA/Cr ratios (p= 0.035) and Lac/Cr ratios (p= 0.019) levels were significantly decreased in cSLE patients when compared with controls. In multivariate analysis, interferon (IFN) gamma (γ) levels (OR = 4.1; 95% 2.01-7.9) and depressive symptoms (OR = 1.9; 95%CI = 1.1-3.2) were associated with NAA/Cr ratio. Increased Cho/Cr was associated with the presence of cognitive impairment (OR = 3.4; p< 0.001; 95%CI = 2.034-5.078). mI/Cr ratio correlated with cumulative glucocorticoids dosage (r = 0.361; p= 0.014). CONCLUSION NAA and CHO ratios may be useful as biomarkers in neuropsychiatric cSLE. Longitudinal studies are necessary to determine whether they predict structural damage.
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Affiliation(s)
- Renan Bazuco Frittoli
- Medical Physiopathology Program-School of Medical Science-, University of Campinas.,Rheumatology Lab, School of Medical Sciences, University of Campinas
| | - Danilo Rodrigues Pereira
- Medical Physiopathology Program-School of Medical Science-, University of Campinas.,Rheumatology Lab, School of Medical Sciences, University of Campinas
| | | | - Mariana Postal
- Rheumatology Lab, School of Medical Sciences, University of Campinas
| | | | | | - Fernando Cendes
- Department of Neurology, Faculty of Medical Science-University of Campinas
| | | | - Leticia Rittner
- School of Electrical and Computer Engineering, University of Campinas
| | - Roberto Marini
- Pediatric Rheumatology Unit, Departament of Pediatrics-, University of Campinas
| | - Timothy B Niewold
- Colton Center for Autoimmunity, NYU School of Medicine, New York, USA
| | - Simone Appenzeller
- Rheumatology Lab, School of Medical Sciences, University of Campinas.,Department of Medicine, Rheumatology Unit, School of Medical Science-University of Campinas
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Li Z, Shang N, Fan G, Li M, Zang Z. Effect of nursing based on the hopeless self-esteem theory plus multi-dimensional intensive nursing for elderly patients with acute cerebral infarction complicated with depression. Am J Transl Res 2021; 13:8450-8457. [PMID: 34377342 PMCID: PMC8340256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/30/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To explore the effect of nursing based on the hopeless self-esteem theory plus multi-dimensional intensive nursing on the self-esteem level and prognosis of elderly patients with acute cerebral infarction (ACI) complicated with depression. METHODS Eighty patients with ACI complicated with depression who were treated in our hospital from September 2018 to September 2020 were selected and randomized into the observation group and the control group (n = 40 each). The observation group received the model of hopeless self-esteem theory combined with multi-dimensional intensive nursing, while the control group received conventional nursing. The clinical efficacy, depression degree, self-esteem level, living ability, quality of life, and attribution mode were compared. RESULTS The overall effective rate was reported at a notably higher rate in the observation group (90.00%) compared to the control group (65.00%) (P < 0.05); After intervention, the observation group had a markedly lower Geriatric Depression Scale (GDS) score than the control group (P < 0.05); After intervention, the observation group showed appreciably higher Rosenberg Self Esteem Scale (RSES) score and Barthel index compared to the control group (P < 0.05); After intervention, the observation group had a remarkably higher level of the quality of life in all dimensions than the control group (P < 0.05); After intervention, there were more positive events in the observation group as compared to the control group (P < 0.05), whereas there were more negative events in the control group as compared to the observation group (P < 0.05). CONCLUSION The hopeless self-esteem theory combined with multi-dimensional intensive nursing can apparently increase the self-esteem level of patients, establish a positive attribution mode, beef up their self-confidence, reduce the degree of depression, upgrade their postoperative living ability and quality of life, and improve prognosis and clinical efficacy.
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Affiliation(s)
- Zhiru Li
- Neurology Department, The First Affiliated Hospital of Qiqihar Medical UniversityQiqihar, China
| | - Ning Shang
- Neurology Department, The First Affiliated Hospital of Qiqihar Medical UniversityQiqihar, China
| | - Guihong Fan
- Nursing Department, The First Affiliated Hospital of Qiqihar Medical UniversityQiqihar, China
| | - Meng Li
- Neurology Department, The First Affiliated Hospital of Qiqihar Medical UniversityQiqihar, China
| | - Zhaoping Zang
- Neurology Department, The First Affiliated Hospital of Qiqihar Medical UniversityQiqihar, China
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Cao Y, Song X, Wang L, Qi Y, Chen Y, Xing Y. Transcranial Doppler Combined With Quantitative Electroencephalography Brain Function Monitoring for Estimating the Prognosis of Patients With Posterior Circulation Cerebral Infarction. Front Neurol 2021; 12:600985. [PMID: 34079507 PMCID: PMC8165540 DOI: 10.3389/fneur.2021.600985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/21/2021] [Indexed: 11/30/2022] Open
Abstract
Posterior circulation cerebral infarction (PCCI) can lead to deceased infratentorial cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional cerebral blood flow both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) is a technique that evaluates neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate the efficacy of TCD-QEEG for predicting the prognosis of patients with PCCI. We used a TCD-QEEG recording system to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta + theta)/(alpha + beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Forty patients (aged 63.7 ± 9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD [hazard ratio (HR) 0.168, confidence interval (CI) 0.047-0.597, p = 0.006] and QEEG indicators of DTABR (HR 12.527, CI 1.637-95.846, p = 0.015) were the independent predictors of the clinical outcomes. The AUROC after combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p < 0.05). TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.
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Affiliation(s)
- Yanting Cao
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- Department of Neurology, Linyi People’s Hospital, Linyi, China
| | - Xiaonan Song
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Lijuan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yajie Qi
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Ying Chen
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yingqi Xing
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
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10
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Mal TK, Tian Y, Patterson AD. Sample Preparation and Data Analysis for NMR-Based Metabolomics. Methods Mol Biol 2021; 2194:301-313. [PMID: 32926373 DOI: 10.1007/978-1-0716-0849-4_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
NMR spectroscopy has become one of the preferred analytical techniques for metabolomics studies due to its inherent nondestructive nature, ability to identify and quantify metabolites simultaneously in a complex mixture, minimal sample preparation requirement, and high degree of experimental reproducibility. NMR-based metabolomics studies involve the measurement and multivariate statistical analysis of metabolites present in biological samples such as biofluids, stool/feces, intestinal content, tissue, and cell extracts by high-resolution NMR spectroscopy-the goal then is to identify and quantify metabolites and evaluate changes of metabolite concentrations in response to some perturbation. Here we describe methodologies for NMR sample preparation of biofluids (serum, saliva, and urine) and stool/feces, intestinal content, and tissues for NMR experiments including extraction of polar metabolites and application of NMR in metabolomics studies. One dimensional (1D) 1H NMR experiments with different variations such as pre-saturation, relaxation-edited, and diffusion-edited are routinely acquired for profiling and metabolite identification and quantification. 2D homonuclear 1H-1H TOCSY and COSY, 2D J-resolved, and heteronuclear 1H-13C HSQC and HMBC are also performed to assist with metabolite identification and quantification. The NMR data are then subjected to targeted and/or untargeted multivariate statistical analysis for biomarker discovery, clinical diagnosis, toxicological studies, molecular phenotyping, and functional genomics.
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Affiliation(s)
- Tapas K Mal
- Department of Chemistry, Pennsylvania State University, University Park, PA, USA.
| | - Yuan Tian
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA, USA
| | - Andrew D Patterson
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA, USA
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11
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Sun X, Zhao B, Qu H, Chen S, Hao X, Chen S, Qin Z, Chen G, Fan Y. Sera and lungs metabonomics reveals key metabolites of resveratrol protecting against PAH in rats. Biomed Pharmacother 2021; 133:110910. [PMID: 33378990 DOI: 10.1016/j.biopha.2020.110910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/12/2020] [Accepted: 10/18/2020] [Indexed: 01/13/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a type of high morbidity and mortality disease. Currently, the intrinsic metabolic alteration and potential mechanism of PAH are still not fully uncovered. Previously, we have found that polyphenol resveratrol (Rev) reversed the remodeling of the pulmonary vasculature and decreased the number of mitochondria in pulmonary arterial smooth muscle cells (PASMCs) (Lei Yu et al. (2017)). However, potential effects of Rev on the changed metabolic molecules derived from lung tissue and serum have no fully elucidated. Thus, we conducted a systematic elaboration through the metabonomics method. Various of metabolites in different pathways including amino acid metabolism, tricarboxylic acid cycle (TCA), acetylcholine metabolism, fatty acid metabolism and biosynthesis in male Wistar rats' sera and lung tissues were explored in three groups (normal group, PAH group, PAH and Rev treatment group). We found that leucine and isoleucine degradation, valine, leucine and isoleucine biosynthesis, tryptophan metabolism and aminoacyl-tRNA biosynthesis were involved in the development of PAH. Hydroxyphenyllactic, isopalmitic acid and cytosine might be significant key metabolites. Further work in this area may inform personalized treatment approaches in clinical practice of PAH through elucidating pathophysiology mechanisms of experimental verification.
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Affiliation(s)
- Xiangju Sun
- Department of Pharmacy, Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Baoshan Zhao
- College of Basic Medical Sciences, Harbin Medical University, Daqing, 163319, China
| | - Huichong Qu
- College of Pharmacy, Harbin Medical University, Daqing, 163319, China
| | - Shuo Chen
- College of Pharmacy, Harbin Medical University, Daqing, 163319, China
| | - Xuewei Hao
- Inspection Institute, Harbin Medical University, Daqing, Heilongjiang Province, 163319, China
| | - Siyue Chen
- College of Pharmacy, Harbin Medical University, Daqing, 163319, China
| | - Zhuwen Qin
- College of Pharmacy, Harbin Medical University, Daqing, 163319, China
| | - Guoyou Chen
- College of Pharmacy, Harbin Medical University, Daqing, 163319, China.
| | - Yuhua Fan
- College of Basic Medical Sciences, Harbin Medical University, Daqing, 163319, China.
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12
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Frittoli RB, Pereira DR, Rittner L, Appenzeller S. Proton magnetic resonance spectroscopy ( 1H-MRS) in rheumatic autoimmune diseases: A systematic review. Lupus 2020; 29:1873-1884. [PMID: 33019878 DOI: 10.1177/0961203320961466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/PURPOSE Proton magnetic resonance spectroscopy (1H-MRS) has been shown to be an important non-invasive tool to quantify neuronal loss or damage in the investigation of central nervous system (CNS) disorders. The purpose of this article is to discuss the clinical utility of 1H-MRS in determining CNS involvement in individuals with rheumatic autoimmune diseases. METHODS This study is a systematic review of the literature, conducted during the month of November and December of 2019 of articles published in the last 16 years (2003-2019). The search for relevant references was done through the exploration of electronic databases (PubMed/Medline and Embase). We searched for studied including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), juvenile idiopathic arthritis, rheumatoid arthritis (RA), psoriasis, Sjögren's syndrome (pSS), vasculitis and Behçet. Only studies published after 2003 and with more than 20 patients were included. RESULTS We included 26 articles. NAA/Cr ratios were significant lower and Cho/Cr ratios increased in several brain regions in SLE, SS, RA, SSc. Associations with disease activity, inflammatory markers, CNS manifestations and comorbidities was variable across studies and diseases. CONCLUSION The presence of neurometabolite abnormalities in patients without ouvert CNS manifestations, suggests that systemic inflammation, atherosclerosis or abnormal vascular reactivity may be associated with subclinical CNS manifestations. MRS may be a usefull non-invasive method for screening patients with risk for CNS manifestations.
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Affiliation(s)
| | | | - Leticia Rittner
- School of Electrical and Computer Engineering, University of Campinas
| | - Simone Appenzeller
- Rheumatology Lab, School of Medical Sciences, University of Campinas.,Pediatric Rheumatology Unit, School of Medical Sciences, University of Campinas.,Department of Medicine, Rheumatology Unit, School of Medical Sciences, University of Campinas
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13
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Momosaka D, Togao O, Kikuchi K, Kikuchi Y, Wakisaka Y, Hiwatashi A. Correlations of amide proton transfer-weighted MRI of cerebral infarction with clinico-radiological findings. PLoS One 2020; 15:e0237358. [PMID: 32790705 PMCID: PMC7425944 DOI: 10.1371/journal.pone.0237358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/23/2020] [Indexed: 01/01/2023] Open
Abstract
Objective To clarify the relationship between amide proton transfer-weighted (APTW) signal, which reflects intracellular pH, and clinico-radiological findings in patients with hyperacute to subacute cerebral infarction. Materials and methods Twenty-nine patients (median age, 70 years [IQR, 54 to 74]; 15 men) were retrospectively examined. The 10th, 25th, 50th, 75th, and 90th percentiles of APTW signal (APT10, APT25, APT50, APT75 and APT90, respectively) were measured within the infarction region-of-interest (ROI), and compared between poor prognosis and good prognosis groups (modified Rankin Scale [mRS] score ≥2 and mRS score <2, respectively). Correlations between APTW signal and time after onset, lesion size, National Institutes of Health Stroke Scale (NIHSS) score, mRS score, and mean apparent diffusion coefficient (ADC) were evaluated. Results The poor prognosis group had lower APT50, APT75, and APT90 than the good prognosis group (–0.66 [–1.19 to –0.27] vs. –0.09 [–0.62 to –0.21]; –0.27 [–0.63 to –0.01] vs. 0.31 [–0.15 to 1.06]; 0.06 [–0.21 to 0.34] vs. 0.93 [0.36 to 1.50] %; p <0.05, respectively). APT50 was positively correlated with time after onset (r = 0.37, p = 0.0471) and negatively with lesion size (r = –0.39, p = 0.0388). APT75 and APT90 were negatively correlated with NIHSS (r = –0.41 and –0.43; p <0.05, respectively). APT50, APT75 and APT90 were negatively correlated with mRS (r = –0.37, –0.52 and –0.57; p <0.05, respectively). APT10 and APT25 were positively correlated with mean ADC (r = 0.37 and 0.38; p <0.05, respectively). Conclusion We demonstrated correlations between APTW signals of infarctions and clinico-radiological findings in patients with hyperacute to subacute infarctions. The poor prognosis group had a lower APTW signal than the good prognosis group. APTW signal was reduced in large infarctions, infarctions with low ADC, and in patients with high NIHSS and mRS scores.
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Affiliation(s)
- Daichi Momosaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshitomo Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinobu Wakisaka
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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14
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Pareek V, Nath B, Roy PK. Role of Neuroimaging Modality in the Assessment of Oxidative Stress in Brain: A Comprehensive Review. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2019; 18:372-381. [DOI: 10.2174/1871527318666190507102340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 12/31/2022]
Abstract
Background & Objective:Oxidative stress (OS) is the secondary source of an injury in consequence to the earlier caused primary injury; it is the condition of an imbalance between oxidants and antioxidants within the physiological system. OS causes alterations in proteins and DNA structure, leading to inflammation, apoptotic cell death, and tissue damage. Neurodegenerative diseases (NDDs) such as Alzheimer's disease, Parkinson's disease, Glioma-induced neurodegeneration and the normal aging-related neuro-degeneration are primarily associated with the increased OS. The present review article is committed to delivering a comprehensive overview of the current neuroimaging modalities which estimates an indirect correlate of OS in the brain. OS-induced changes in white matter tracts and the gray matter volumes are reviewed assessing the role of diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) respectively. Further, the role of magnetic resonance spectroscopy (MRS) to assess the OS-induced alterations of chemical moieties, and thus the resultant structural implications in the neurological disorders are also briefly as well as precisely reviewed.Conclusions:In the present review article we present an overview of the role of neuroimaging modalities in the diagnosis, and longitudinal assessment during treatment of the OS induced changes.
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Affiliation(s)
- Vikas Pareek
- National Neuroimaging Facility, Computational Neuroscience & Neuroimaging Department, National Brain Research Center, Manesar, Haryana, 122052, India
| | - Banshi Nath
- CERVO Brain Research Centre, Quebec QC, Canada
| | - Prasun K. Roy
- Computational Neuroscience & Neuro-Imaging Laboratory, School of Biomedical Engineering, Indian Institute of Technology (BHU), Varanasi 122005, India
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15
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Emwas AH, Roy R, McKay RT, Tenori L, Saccenti E, Gowda GAN, Raftery D, Alahmari F, Jaremko L, Jaremko M, Wishart DS. NMR Spectroscopy for Metabolomics Research. Metabolites 2019; 9:E123. [PMID: 31252628 PMCID: PMC6680826 DOI: 10.3390/metabo9070123] [Citation(s) in RCA: 519] [Impact Index Per Article: 103.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 12/14/2022] Open
Abstract
Over the past two decades, nuclear magnetic resonance (NMR) has emerged as one of the three principal analytical techniques used in metabolomics (the other two being gas chromatography coupled to mass spectrometry (GC-MS) and liquid chromatography coupled with single-stage mass spectrometry (LC-MS)). The relative ease of sample preparation, the ability to quantify metabolite levels, the high level of experimental reproducibility, and the inherently nondestructive nature of NMR spectroscopy have made it the preferred platform for long-term or large-scale clinical metabolomic studies. These advantages, however, are often outweighed by the fact that most other analytical techniques, including both LC-MS and GC-MS, are inherently more sensitive than NMR, with lower limits of detection typically being 10 to 100 times better. This review is intended to introduce readers to the field of NMR-based metabolomics and to highlight both the advantages and disadvantages of NMR spectroscopy for metabolomic studies. It will also explore some of the unique strengths of NMR-based metabolomics, particularly with regard to isotope selection/detection, mixture deconvolution via 2D spectroscopy, automation, and the ability to noninvasively analyze native tissue specimens. Finally, this review will highlight a number of emerging NMR techniques and technologies that are being used to strengthen its utility and overcome its inherent limitations in metabolomic applications.
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Affiliation(s)
- Abdul-Hamid Emwas
- Core Labs, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Raja Roy
- Centre of Biomedical Research, Formerly, Centre of Biomedical Magnetic Resonance, Sanjay Gandhi Post-Graduate Institute of Medical Sciences Campus, Uttar Pradesh 226014, India
| | - Ryan T McKay
- Department of Chemistry, University of Alberta, Edmonton, AB T6G 2W2, Canada
| | - Leonardo Tenori
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Edoardo Saccenti
- Laboratory of Systems and Synthetic Biology Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - G A Nagana Gowda
- Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington, 850 Republican St., Seattle, WA 98109, USA
| | - Daniel Raftery
- Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington, 850 Republican St., Seattle, WA 98109, USA
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue, Seattle, WA 98109, USA
| | - Fatimah Alahmari
- Department of NanoMedicine Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman bin Faisal University, Dammam 31441, Saudi Arabia
| | - Lukasz Jaremko
- Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Mariusz Jaremko
- Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - David S Wishart
- Department of Biological Sciences, University of Alberta, Edmonton, AB T6G 2E8, Canada
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16
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Advanced Neuroimaging Techniques for Difficult Diagnoses. J Craniofac Surg 2018; 29:e757-e759. [DOI: 10.1097/scs.0000000000004711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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17
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Abe T, Niizuma K, Kanoke A, Saigusa D, Saito R, Uruno A, Fujimura M, Yamamoto M, Tominaga T. Metabolomic Analysis of Mouse Brain after a Transient Middle Cerebral Artery Occlusion by Mass Spectrometry Imaging. Neurol Med Chir (Tokyo) 2018; 58:384-392. [PMID: 30078821 PMCID: PMC6156127 DOI: 10.2176/nmc.oa.2018-0054] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
We performed metabolomic analyses of mouse brain using a transient middle cerebral artery occlusion (tMCAO) model with Matrix Assisted Laser Desorption/Ionization (MALDI)-mass spectrometry imaging (MSI) to reveal metabolite changes after cerebral ischemia. We selected and analyzed three metabolites, namely creatine (Cr), phosphocreatine (P-Cr), and ceramides (Cer), because these metabolites contribute to cell life and death. Eight-week-old male C57BL/6J mice were subjected to tMCAO via the intraluminal blockade of the middle cerebral artery (MCA) and reperfusion 60 min after the induction of ischemia. Each mouse was randomly assigned to one of the three groups; the groups were defined by the survival period after reperfusion: control, 1 h, and 24 h. Corrected samples were analyzed using MALDI-MSI. Results of MSI analysis showed the presence of several ionized substances and revealed spatial changes in some metabolites identified as precise substances, including Cr, P-Cr, Cer d18:1/18:0, phosphatidylcholine, L-glutamine, and L-histidine. Cr, P-Cr, and Cer d18:1/18:0 were changed after tMCAO, and P-Cr and Cer d18:1/18:0 accumulated over time in ischemic cores and surrounding areas following ischemia onset. The upregulation of P-Cr and Cer d18:1/18:0 was detected 1 h after tMCAO when no changes were evident on hematoxylin and eosin staining and immunofluorescence assay. P-Cr and Cer d18:1/18:0 can serve as neuroprotective therapies because they are biomarker candidates for cerebral ischemia.
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Affiliation(s)
- Takatsugu Abe
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine.,Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine.,Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University
| | - Atsushi Kanoke
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Daisuke Saigusa
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
| | - Ritsumi Saito
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
| | - Akira Uruno
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
| | - Miki Fujimura
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
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18
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Zacharzewska-Gondek A, Maksymowicz H, Szymczyk M, Sąsiadek M, Bladowska J. Cerebral Metastases of Lung Cancer Mimicking Multiple Ischaemic Lesions - A Case Report and Review of Literature. Pol J Radiol 2018; 82:530-535. [PMID: 29662584 PMCID: PMC5894122 DOI: 10.12659/pjr.902213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/21/2016] [Indexed: 01/01/2023] Open
Abstract
Background Restricted diffusion that is found on magnetic resonance diffusion-weighted imaging (DWI) typically indicates acute ischaemic stroke. However, restricted diffusion can also occur in other diseases, like metastatic brain tumours, which we describe in this case report. Case Report A 57-year-old male, with a diagnosis of small-cell cancer of the right lung (microcellular anaplastic carcinoma), was admitted with focal neurological symptoms. Initial brain MRI revealed multiple, disseminated lesions that were hyperintense on T2-weighted images and did not enhance after contrast administration; notably, some lesions manifested restricted diffusion on DWI images. Based on these findings, disseminated ischaemic lesions were diagnosed. On follow-up MRI that was performed after 2 weeks, we observed enlargement of the lesions; there were multiple, disseminated, sharply outlined, contrast-enhancing, oval foci with persistent restriction of diffusion. We diagnosed the lesions as disseminated brain metastases due to lung cancer. To our knowledge, this is the first description of a patient with brain metastases that were characterised by restricted diffusion and no contrast enhancement. Conclusions Multiple, disseminated brain lesions, that are characterised by restricted diffusion on DWI, typically indicate acute or hyperacute ischemic infarcts; however, they can also be due to hypercellular metastases, even if no contrast enhancement is observed. This latter possibility should be considered particularly in patients with cancer.
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Affiliation(s)
- Anna Zacharzewska-Gondek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Hanna Maksymowicz
- Department of General Radiology, Interventional Radiology and Neuroradiology, University Hospital Wrocław, Wrocław, Poland
| | | | - Marek Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Joanna Bladowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, Wrocław, Poland
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Magnetic Resonance Spectroscopy and its Clinical Applications: A Review. J Med Imaging Radiat Sci 2017; 48:233-253. [PMID: 31047406 DOI: 10.1016/j.jmir.2017.06.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 04/30/2017] [Accepted: 06/22/2017] [Indexed: 12/25/2022]
Abstract
In vivo NMR spectroscopy is known as magnetic resonance spectroscopy (MRS). MRS has been applied as both a research and a clinical tool in order to detect visible or nonvisible abnormalities. The adaptability of MRS allows a technique that can probe a wide variety of metabolic uses across different tissues. Although MRS is mostly applied for brain tissue, it can be used for detection, localization, staging, tumour aggressiveness evaluation, and tumour response assessment of breast, prostate, hepatic, and other cancers. In this article, the medical applications of MRS in the brain, including tumours, neural and psychiatric disorder studies, breast, prostate, hepatic, gastrointestinal, and genitourinary investigations have been reviewed.
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20
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Roy U, Das SK, Mukherjee A, Biswas D, Pan K, Biswas A, Panwar A. Irreversible Hemichorea-Hemiballism in a Case of Nonketotic Hyperglycemia Presenting as the Initial Manifestation of Diabetes Mellitus. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2016; 6:393. [PMID: 27679748 PMCID: PMC5019112 DOI: 10.7916/d8qz2b3f] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/07/2016] [Indexed: 12/01/2022]
Abstract
Background Hemichorea–hemiballism (HCHB) is a hyperkinetic movement
disorder with features of both chorea and ballism occurring on the same side. Case report We present a case of HCHB due to nonketotic hyperglycemia (NKH) that
was the initial presentation of diabetes and was irreversible clinically even
after 6 months of optimal blood sugar control. Discussion Although HCHB due to hyperglycemia is a potentially reversible condition in the
majority of patients, prolonged uncontrolled hyperglycemia may cause ischemic
insult and persistent symptoms. Hyperglycemia should always be kept in the list of
differentials while dealing with patients who are newly diagnosed with HCHB.
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Affiliation(s)
- Ujjawal Roy
- Bangur Institute of Neurosciences, IPGMER, Kolkata, India
| | | | | | | | - Koushik Pan
- Bangur Institute of Neurosciences, IPGMER, Kolkata, India
| | - Atanu Biswas
- Bangur Institute of Neurosciences, IPGMER, Kolkata, India
| | - Ajay Panwar
- King George's Medical University, Lucknow, India
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21
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Ryu B, Kawamata T, Wakai T, Shimizu M, Yagi S, Shimizu T. Reversible Cerebral Metabolism Changes Using Proton Magnetic Resonance Spectroscopy in a Patient with Intracranial Dural Arteriovenous Fistula: A Case Report. World Neurosurg 2016; 92:584.e1-584.e6. [PMID: 27245562 DOI: 10.1016/j.wneu.2016.05.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/18/2016] [Accepted: 05/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cerebral metabolism can be disrupted by venous congestion in patients with intracranial dural arteriovenous fistula (DAVF), which may lead to adverse neurological outcomes. However, there are no clear indicators to guide cerebral evaluation and treatment selection in cases of DAVF. We describe a patient with a DAVF whose proton magnetic resonance spectroscopy ((1)H-MRS) findings were associated with improvements in clinical status. CASE DESCRIPTION An elderly woman with a history of myocardial infarction presented with progressive dementia, aphasia, and a severe headache. We detected a transverse-sigmoid sinus DAVF, as well as abnormal levels of lactate and N-acetylaspartic acid (NAA) in the (1)H-MRS, and successfully treated the patient using surgical sinus skeletonization. However, follow-up (1)H-MRS revealed inconsistent reversals in the levels of lactate and NAA. In addition, we calculated the NAA/creatinine ratios from before and after surgery, which revealed postoperative increases in the ratios for the left temporal, right parietal, and left parietal regions. These increases occurred concurrently with improvements in the patient's cognitive function. CONCLUSIONS (1)H-MRS may be useful for pretreatment detection of increased lactate levels, decreased NAA levels, and/or decreased NAA/creatinine ratios. These findings may indicate poorer cerebral metabolism, and show a need for more aggressive treatment. Furthermore, (1)H-MRS may be useful for evaluating the effect of conservative treatment and for indicating conversion to a more aggressive treatment.
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Affiliation(s)
- Bikei Ryu
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Saitama, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takuma Wakai
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Saitama, Japan
| | - Masahiro Shimizu
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Saitama, Japan
| | - Shinichi Yagi
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Saitama, Japan
| | - Tsuneo Shimizu
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Saitama, Japan
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Zhang T, Wang W, Huang J, Liu X, Zhang H, Zhang N. Metabolomic investigation of regional brain tissue dysfunctions induced by global cerebral ischemia. BMC Neurosci 2016; 17:25. [PMID: 27206925 PMCID: PMC4875627 DOI: 10.1186/s12868-016-0256-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 05/11/2016] [Indexed: 11/14/2022] Open
Abstract
Background To get a broader view of global ischemia-induced cerebral disorders at the metabolic level, a nuclear magnetic resonance-based metabolomic study was performed to evaluate the metabolic profile changes on regional brain tissues of female and male mice upon bilateral common carotid arteries occlusion (BCCAO) operation. Results Significant metabolic disorders were observed in both cerebral cortex and hippocampus tissues of the experimental mice upon global cerebral ischemic attack. Multiple amino acids were identified as the dominantly perturbed metabolites. It was also shown that although the metabolic profile change patterns in the brain tissues were quite similar in male and female BCCAO mice, metabolic disorders in the cortex tissues were more severe in the female mice than in the male mice. Conclusions In the present study, significant changes in amino acid metabolic pathways were confirmed in the early stage of global ischemia. Meanwhile, cerebral metabolic dysfunctions were more severe in the female BCCAO mice than in the male mice, suggesting that gender may play a role in different metabolic responses to the ischemic attack, which may provide an important hypothesis for a better understanding of the clinically observed gender-dependent pathological outcome of cerebral ischemia. Electronic supplementary material The online version of this article (doi:10.1186/s12868-016-0256-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tianshu Zhang
- Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai, 200237, China
| | - Wei Wang
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Jin Huang
- Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai, 200237, China
| | - Xia Liu
- Department of Analytical Chemistry, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
| | - Haiyan Zhang
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
| | - Naixia Zhang
- Department of Analytical Chemistry, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
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Chauhan A, Sharma U, Jagannathan NR, Gupta YK. Rapamycin ameliorates brain metabolites alterations after transient focal ischemia in rats. Eur J Pharmacol 2015; 757:28-33. [DOI: 10.1016/j.ejphar.2015.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/19/2015] [Accepted: 03/01/2015] [Indexed: 11/30/2022]
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