Broadband proton decoupling for in vivo brain spectroscopy in humans

SORDOR pulses: expansion of the Böhlen-Bodenhausen scheme for low-power broadband magnetic resonance

A novel type of efficient broadband pulse, called second-order phase dispersion by optimised rotation (SORDOR), has recently been introduced. In contrast to adiabatic excitation, SORDOR-90 pulses provide effective transverse 90∘ rotations throughout their bandwidth, with a quadratic offset dependence of the phase in the x , y plane. Together with phase-matched SORDOR-180 pulses, this enables the Böhlen-Bodenhausen broadband refocusing approach for linearly frequency-swept pulses to be extended to any type of 90∘ /180∘ pulse-delay sequence. Example pulse shapes are characterised in theory and experiment, and an example application is given with a 19 F -PROJECT experiment for measuring relaxation times with reduced distortions due to J -coupling evolution.

Mobile Phone Radiation Deflects Brain Energy Homeostasis and Prompts Human Food Ingestion

Obesity and mobile phone usage have simultaneously spread worldwide. Radio frequency-modulated electromagnetic fields (RF-EMFs) emitted by mobile phones are largely absorbed by the head of the user, influence cerebral glucose metabolism, and modulate neuronal excitability. Body weight adjustment, in turn, is one of the main brain functions as food intake behavior and appetite perception underlie hypothalamic regulation. Against this background, we questioned if mobile phone radiation and food intake may be related. In a single-blind, sham-controlled, randomized crossover comparison, 15 normal-weight young men (23.47 ± 0.68 years) were exposed to 25 min of RF-EMFs emitted by two different mobile phone types vs. sham radiation under fasting conditions. Spontaneous food intake was assessed by an ad libitum standard buffet test and cerebral energy homeostasis was monitored by ³¹phosphorus-magnetic resonance spectroscopy measurements. Exposure to both mobile phones strikingly increased overall caloric intake by 22–27% compared with the sham condition. Differential analyses of macronutrient ingestion revealed that higher calorie consumption was mainly due to enhanced carbohydrate intake. Measurements of the cerebral energy content, i.e., adenosine triphosphate and phosphocreatine ratios to inorganic phosphate, displayed an increase upon mobile phone radiation. Our results identify RF-EMFs as a potential contributing factor to overeating, which underlies the obesity epidemic. Beyond that, the observed RF-EMFs-induced alterations of the brain energy homeostasis may put our data into a broader context because a balanced brain energy homeostasis is of fundamental importance for all brain functions. Potential disturbances by electromagnetic fields may therefore exert some generalized neurobiological effects, which are not yet foreseeable.

Hypocaloric Dieting Unsettles the Neuroenergetic Homeostasis in Humans

Background: The effects of low-calorie dieting in obesity are disappointing in the long run. The brain’s energy homeostasis plays a key role in the regulation of body weight. We hypothesized that the cerebral energy status underlies an adaptation process upon body weight loss due to hypocaloric dieting in humans. Objective: We instructed 26 healthy obese participants to reduce body weight via replacement of meals by a commercial diet product for two weeks. The cerebral energy status was assessed by ³¹ phosphorus magnetic resonance spectroscopy (31 PMRS) before and after low-caloric dieting as well as at follow-up. A standardized test buffet was quantified after body weight loss and at follow-up. Blood glucose metabolism and neurohormonal stress axis activity were monitored. Results: Weight loss induced a decline in blood concentrations of insulin (p = 0.002), C-peptide (p = 0.005), ACTH (p = 0.006), and norepinephrine (p = 0.012). ATP/Pi (p = 0.003) and PCr/Pi ratios (p = 0.012) were increased and NADH levels reduced (p = 0.041) after hypocaloric dieting. At follow-up, weight loss persisted (p < 0.001), while insulin, C-peptide, and ACTH increased (p < 0.005 for all) corresponding to baseline levels again. Despite repealed hormonal alterations, ratios of PCr/Pi remained higher (p = 0.039) and NADH levels lower (p = 0.007) 6 weeks after ending the diet. ATP/Pi ratios returned to baseline levels again (p = 0.168). Conclusion: Low-calorie dieting reduces neurohormonal stress axis activity and increases the neuroenergetic status in obesity. This effect was of a transient nature in terms of stress hormonal measures. In contrast, PCr/Pi ratios remained increased after dieting and at follow-up while NADH levels were still reduced, which indicates a persistently unsettled neuroenergetic homeostasis upon diet-induced rapid body weight loss.

A 16-Channel 13C Array Coil for Magnetic Resonance Spectroscopy of the Breast at 7T

OBJECTIVE

Considering the reported elevation of ω-6/ω-3 fatty acid ratios in breast neoplasms, one particularly important application of ¹³C MRS could be in more fully understanding the breast lipidome's relationship to breast cancer incidence. However, the low natural abundance and gyromagnetic ratio of the ¹³C isotope lead to detection sensitivity challenges. Previous ¹³C MRS studies have relied on the use of small surface coils with limited field-of-view and shallow penetration depths to achieve adequate signal-to-noise ratio (SNR), and the use of receive array coils is still mostly unexplored.

METHODS

This work presents a unilateral breast 16-channel ¹³C array coil and interfacing hardware designed to retain the surface sensitivity of a single small loop coil while improving penetration depth and extending the field-of-view over the entire breast at 7T. The coil was characterized through bench measurements and phantom ¹³C spectroscopy experiments.

RESULTS

Bench measurements showed receive coil matching better than -17 dB and average preamplifier decoupling of 16.2 dB with no evident peak splitting. Phantom MRS studies show better than a three-fold increase in average SNR over the entirety of the breast region compared to volume coil reception alone as well as an ability for individual array elements to be used for coarse metabolite localization without the use of single-voxel or spectroscopic imaging methods.

CONCLUSION

Our current study has shown the benefits of the array. Future in vivo lipidomics studies can be pursued.

SIGNIFICANCE

Development of the 16-channel breast array coil opens possibilities of in vivo lipidomics studies to elucidate the link between breast cancer incidence and lipid metabolics.

Double transcranial direct current stimulation of the brain increases cerebral energy levels and systemic glucose tolerance in men

Transcranial direct current stimulation (tDCS) is a neuromodulatory method that has been tested experimentally and has already been used as an adjuvant therapeutic option to treat a number of neurological disorders and neuropsychiatric diseases. Beyond its well known local effects within the brain, tDCS also transiently promotes systemic glucose uptake and reduces the activity of the neurohormonal stress axes. We aimed to test whether the effects of a single tDCS application could be replicated upon double stimulation to persistently improve systemic glucose tolerance and stress axes activity in humans. In a single-blinded cross-over study, we examined 15 healthy male volunteers. Anodal tDCS vs sham was applied twice in series. Systemic glucose tolerance was investigated by the standard hyperinsulinaemic-euglycaemic glucose clamp procedure, and parameters of neurohormonal stress axes activity were measured. Because tDCS-induced brain energy consumption has been shown to be part of the mechanism underlying the assumed effects, we monitored the cerebral high-energy phosphates ATP and phosphocreatine by ³¹ phosphorus magnetic resonance spectroscopy. As hypothesised, analyses revealed that double anodal tDCS persistently increases glucose tolerance compared to sham. Moreover, we observed a significant rise in cerebral high-energy phosphate content upon double tDCS. Accordingly, the activity of the neurohormonal stress axes was reduced upon tDCS compared to sham. Our data demonstrate that double tDCS promotes systemic glucose uptake and reduces stress axes activity in healthy humans. These effects suggest that repetitive tDCS may be a future non-pharmacological option for combating glucose intolerance in type 2 diabetes patients.

Psychosocial stress promotes food intake and enhances the neuroenergetic level in men

Psychosocial stress may lead to increased food consumption and overweight. In turn, obesity is related to reduced brain energy content. We hypothesized that psychosocial stress influencing food intake may alter the neuroenergetic status in the human brain. We tested 14 healthy normal weight men in a randomized crossover design. A modified version of the Trier Social Stress Test (TSST) was carried out to induce psychosocial stress vs. control in a neuroimaging setting. Cerebral energy content, i.e. high energy phosphates adenosine triphosphate (ATP) and phosphocreatine (PCr), was measured by ³¹phosphorus magnetic resonance spectroscopy. Food intake was quantified by an ad libitum buffet test. Stress hormonal response and alterations in glucose metabolism were monitored by blood sampling. Before data collection, we mainly expected a stress-induced reduction in cerebral high energy phosphates, followed by higher food intake. Psychosocial stress increased serum cortisol concentrations (p = .003) and fat intake of all participants by 25% (p = .043), as well as food intake of "stress-eaters" by 41.1% (p = .003) compared with controls. Blood glucose and insulin concentrations were not affected (p > .174 for both). Cerebral ATP and PCr levels generally increased upon stress-induction (p > = .022 and p = .037, respectively). Our data confirm that psychosocial stress may enhance food intake. Contrary to our expectations, stress induces a distinct increase in the neuroenergetic status. This insight suggests that the underlying central nervous mechanisms of stress-induced overeating may involve the regulation of the brain energy homeostasis.

Impaired brain energy gain upon a glucose load in obesity

BACKGROUND

There is evidence that the brain's energy status is lowered in obesity despite of chronic hypercaloric nutrition. The underlying mechanisms are unknown. We hypothesized that the brain of obese people does not appropriately generate energy in response to a hypercaloric supply.

METHODS

Glucose was intravenously infused in 17 normal weights and 13 obese participants until blood glucose concentrations reached the postprandial levels of 7 mmol/L and 10 mmol/L. Changes in cerebral adenosine triphosphate (ATP) and phosphocreatine (PCr) content were measured by ³¹phosphorus magnetic resonance spectroscopy and stress hormonal measures regulating glucose homeostasis were monitored. Because vitamin C is crucial for a proper neuronal energy synthesis we determined circulating concentrations during the experimental testing.

RESULTS

Cerebral high-energy phosphates were increased at blood glucose levels of 7 mmol/L in normal weights, which was completely missing in the obese. Brain energy content moderately raised only at blood glucose levels of 10 mmol/L in obese participants. Vitamin C concentrations generally correlated with the brain energy content at blood glucose concentrations of 7 mmol/L.

CONCLUSIONS

Our data demonstrate an inefficient cerebral energy gain upon a glucose load in obese men, which may result from a dysfunctional glucose transport across the blood-brain barrier or a downregulated energy synthesis in mitochondrial oxidation processes. Our finding offers an explanation for the chronic neuroenergetic deficiency and respectively missing satiety perception in obesity.

High Field In vivo13C Magnetic Resonance Spectroscopy of Brain by Random Radiofrequency Heteronuclear Decoupling and Data Undersampling

In vivo¹³C magnetic resonance spectroscopy (MRS) is a unique and effective tool for studying dynamic human brain metabolism and the cycling of neurotransmitters. One of the major technical challenges for in vivo¹³C-MRS is the high radio frequency (RF) power necessary for heteronuclear decoupling. In the common practice of in vivo¹³C-MRS, alkanyl carbons are detected in the spectra range of 10-65 ppm. The amplitude of decoupling pulses has to be significantly greater than the large one-bond ¹H-¹³C scalar coupling (¹J_CH = 125-145 Hz). Two main proton decoupling methods have been developed: broadband stochastic decoupling and coherent composite or adiabatic pulse decoupling (e.g., WALTZ); the latter is widely used because of its efficiency and superb performance under inhomogeneous B₁ field. Because the RF power required for proton decoupling increases quadratically with field strength, in vivo¹³C-MRS using coherent decoupling is often limited to lowmagnetic fields [<=4 Tesla (T)] to keep the local and averaged specific absorption rate (SAR) under the safety guidelines established by the International Electrotechnical Commission (IEC) and the US Food and Drug Administration (FDA). Alternately, carboxylic/amide carbons are coupled to protons via weak long-range ¹H-¹³C scalar couplings, which can be decoupled using low RF power broadband stochastic decoupling. Recently, the carboxylic/amide ¹³C-MRS technique using low power random RF heteronuclear decoupling was safely applied to human brain studies at 7T. Here, we review the two major decoupling methods and the carboxylic/amide ¹³C-MRS with low power decoupling strategy. Further decreases in RF power deposition by frequency-domain windowing and time-domain random under-sampling are also discussed. Low RF power decoupling opens the possibility of performing in vivo¹³C experiments of human brain at very high magnetic fields (such as 11.7T), where signal-to-noise ratio as well as spatial and temporal spectral resolution are more favorable than lower fields.

Oxidation of [U-13 C]glucose in the human brain at 7T under steady state conditions

PURPOSE

Disorders of brain energy metabolism and neurotransmitter recycling have been implicated in multiple neurological conditions. ¹³ C magnetic resonance spectroscopy (¹³ C MRS) during intravenous administration of ¹³ C-labeled compounds has been used to measure turnover rates of brain metabolites. This approach, however, requires prolonged infusion inside the magnet. Proton decoupling is typically required but may be difficult to implement with standard equipment. We examined an alternative approach to monitor glucose metabolism in the human brain.

METHODS

¹³ C-enriched glucose was infused in healthy subjects outside the magnet to a steady-state level of ¹³ C enrichment. Subsequently, the subjects were scanned at 7T for 60 min without ¹ H decoupling. Metabolic modeling was used to calculate anaplerosis.

RESULTS

Biomarkers of energy metabolism and anaplerosis were detected. The glutamate C5 doublet provided information about glucose-derived acetyl-coenzyme A flux into the tricarboxylic acid (TCA) cycle via pyruvate dehydrogenase, and the bicarbonate signal reflected overall TCA cycle activity. The glutamate C1/C5 ratio is sensitive to anaplerosis.

CONCLUSION

Brain ¹³ C MRS at 7T provides information about glucose oxidation and anaplerosis without the need of prolonged ¹³ C infusions inside the scanner and without technical challenges of ¹ H decoupling, making it a feasible approach for clinical research. Magn Reson Med 78:2065-2071, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Progress towards in vivo brain 13C-MRS in mice: Metabolic flux analysis in small tissue volumes

The combination of dynamic ¹³C MRS data under infusion of ¹³C-labelled substrates and compartmental models of cerebral metabolism enabled in vivo measurement of metabolic fluxes with a quantitative and distinct determination of cellular-specific activities. The non-invasive nature and the chemical specificity of the ¹³C dynamic data obtained in those tracer experiments makes it an attractive approach offering unique insights into cerebral metabolism. Genetically engineered mice present a wealth of disease models particularly interesting for the neuroscience community. Nevertheless, in vivo¹³C NMR studies of the mouse brain are only recently appearing in the field due to the numerous challenges linked to the small mouse brain volume and the difficulty to follow the mouse physiological parameters within the NMR system during the infusion experiment. This review will present the progresses in the quest for a higher in vivo¹³C signal-to-noise ratio up to the present state of the art techniques, which made it feasible to assess glucose metabolism in different regions of the mouse brain. We describe how experimental results were integrated into suitable compartmental models and how a deep understanding of cerebral metabolism depends on the reliable detection of ¹³C in the different molecules and carbon positions.

Reconstruction of randomly under-sampled spectra for in vivo13C magnetic resonance spectroscopy

PURPOSE

Over the past decade, many techniques have been developed to reduce radiofrequency (RF) power deposition associated with proton decoupling in in vivo Carbon-13 (¹³C) magnetic resonance spectroscopy (MRS). In this work we propose a new strategy that uses data under-sampling to achieve reduction in RF power deposition.

MATERIALS AND METHODS

Essentially, proton decoupling is required only during randomly selected segments of data acquisition. By taking advantage of the sparse spectral pattern of the carboxylic/amide region of in vivo¹³C spectra of brain, we developed an iterative algorithm to reconstruct spectra from randomly under-sampled data. Fully sampled data were used as references. Reconstructed spectra were compared with the fully sampled references and evaluated using residuals and relative signal intensity errors.

RESULTS

Numerical simulations and in vivo experiments at 7Tesla demonstrated that this novel decoupling and data processing strategy can effectively reduce decoupling power deposition by greater than 30%.

CONCLUSION

This study proposes and evaluates a novel approach to acquire ¹³C data with reduced proton decoupling power deposition and reconstruct in vivo¹³C spectra of carboxylic/amide metabolite signals using randomly under-sampled data. Because proton decoupling is not needed over a significant portion of data acquisition, this novel approach can effectively reduce the required decoupling power and thus SAR. It opens the possibility of performing in vivo¹³C experiments of human brain at very high magnetic fields.

(13)C MRS of human brain at 7 Tesla using [2-(13)C]glucose infusion and low power broadband stochastic proton decoupling

PURPOSE

Carbon-13 ((13)C) MR spectroscopy (MRS) of the human brain at 7 Tesla (T) may pose patient safety issues due to high radiofrequency (RF) power deposition for proton decoupling. The purpose of present work is to study the feasibility of in vivo (13)C MRS of human brain at 7 T using broadband low RF power proton decoupling.

METHODS

Carboxylic/amide (13)C MRS of human brain by broadband stochastic proton decoupling was demonstrated on a 7 T scanner. RF safety was evaluated using the finite-difference time-domain method. (13)C signal enhancement by nuclear Overhauser effect (NOE) and proton decoupling was evaluated in both phantoms and in vivo.

RESULTS

At 7 T, the peak amplitude of carboxylic/amide (13)C signals was increased by a factor of greater than 4 due to the combined effects of NOE and proton decoupling. The 7 T (13)C MRS technique used decoupling power and average transmit power of less than 35 watts (W) and 3.6 W, respectively.

CONCLUSION

In vivo (13)C MRS studies of human brain can be performed at 7 T, well below the RF safety threshold, by detecting carboxylic/amide carbons with broadband stochastic proton decoupling.

Blunted brain energy consumption relates to insula atrophy and impaired glucose tolerance in obesity

Brain energy consumption induced by electrical stimulation increases systemic glucose tolerance in normal-weight men. In obesity, fundamental reductions in brain energy levels, gray matter density, and cortical metabolism, as well as chronically impaired glucose tolerance, suggest that disturbed neuroenergetic regulation may be involved in the development of overweight and obesity. Here, we induced neuronal excitation by anodal transcranial direct current stimulation versus sham, examined cerebral energy consumption with (31)P magnetic resonance spectroscopy, and determined systemic glucose uptake by euglycemic-hyperinsulinemic glucose clamp in 15 normal-weight and 15 obese participants. We demonstrate blunted brain energy consumption and impaired systemic glucose uptake in obese compared with normal-weight volunteers, indicating neuroenergetic dysregulation in obese humans. Broadening our understanding of reduced multifocal gray matter volumes in obesity, our findings show that reduced appetite- and taste-processing area morphometry is associated with decreased brain energy levels. Specifically, gray matter volumes of the insula relate to brain energy content in obese participants. Overall, our results imply that a diminished cerebral energy supply may underlie the decline in brain areas assigned to food intake regulation and therefore the development of obesity.

Intranasal insulin suppresses food intake via enhancement of brain energy levels in humans

Cerebral insulin exerts anorexic effects in humans and animals. The underlying mechanisms, however, are not clear. Because insulin physiologically facilitates glucose uptake by most tissues of the body and thereby fosters intracellular energy supply, we hypothesized that intranasal insulin reduces food consumption via enhancement of the neuroenergetic level. In a double-blind, placebo-controlled, within-subject comparison, 15 healthy men (BMI 22.2 ± 0.37 kg/m(2)) aged 22-28 years were intranasally administered insulin (40 IU) or placebo after an overnight fast. Cerebral energy metabolism was assessed by (31)P magnetic resonance spectroscopy. At 100 min after spray administration, participants consumed ad libitum from a test buffet. Our data show that intranasal insulin increases brain energy (i.e., adenosine triphosphate and phosphocreatine levels). Cerebral energy content correlates inversely with subsequent calorie intake in the control condition. Moreover, the neuroenergetic rise upon insulin administration correlates with the consecutive reduction in free-choice calorie consumption. Brain energy levels may therefore constitute a predictive value for food intake. Given that the brain synchronizes food intake behavior in dependence of its current energetic status, a future challenge in obesity treatment may be to therapeutically influence cerebral energy homeostasis. Intranasal insulin, after optimizing its application schema, seems a promising option in this regard.

Brain energy consumption induced by electrical stimulation promotes systemic glucose uptake

BACKGROUND

Controlled transcranial stimulation of the brain is part of clinical treatment strategies in neuropsychiatric diseases such as depression, stroke, or Parkinson's disease. Manipulating brain activity by transcranial stimulation, however, inevitably influences other control centers of various neuronal and neurohormonal feedback loops and therefore may concomitantly affect systemic metabolic regulation. Because hypothalamic adenosine triphosphate-sensitive potassium channels, which function as local energy sensors, are centrally involved in the regulation of glucose homeostasis, we tested whether transcranial direct current stimulation (tDCS) causes an excitation-induced transient neuronal energy depletion and thus influences systemic glucose homeostasis and related neuroendocrine mediators.

METHODS

In a crossover design testing 15 healthy male volunteers, we increased neuronal excitation by anodal tDCS versus sham and examined cerebral energy consumption with ³¹phosphorus magnetic resonance spectroscopy. Systemic glucose uptake was determined by euglycemic-hyperinsulinemic glucose clamp, and neurohormonal measurements comprised the parameters of the stress systems.

RESULTS

We found that anodic tDCS-induced neuronal excitation causes an energetic depletion, as quantified by ³¹phosphorus magnetic resonance spectroscopy. Moreover, tDCS-induced cerebral energy consumption promotes systemic glucose tolerance in a standardized euglycemic-hyperinsulinemic glucose clamp procedure and reduces neurohormonal stress axes activity.

CONCLUSIONS

Our data demonstrate that transcranial brain stimulation not only evokes alterations in local neuronal processes but also clearly influences downstream metabolic systems regulated by the brain. The beneficial effects of tDCS on metabolic features may thus qualify brain stimulation as a promising nonpharmacologic therapy option for drug-induced or comorbid metabolic disturbances in various neuropsychiatric diseases.

A comparison of single-voxel clinical in vivo hepatic 31P MR spectra acquired at 1.5 and 3.0 Tesla in health and diseased states

With the increasing availability of human MR scanners at various field strengths, the optimal field strength for in vivo clinical MR studies of the liver has become a focus of attention. Comparison between results at 3.0 and 1.5 T is of particular clinical interest, especially for multicentre studies. For MRS studies, higher field strengths should be advantageous, because improved sensitivity and chemical shift dispersion are expected. We report a comparison between single-voxel hepatic proton-decoupled (31)P MRS performed at 1.5 and 3.0 T in the same subjects using similar methodologies. Twelve healthy volunteers and 15 patients with chronic liver disease were studied. Improved spectral resolution was achieved using proton decoupling, and there was an improvement (21%) in the signal-to-noise ratio (SNR) of the phosphomonoester (PME) resonance at 3.0 T relative to 1.5 T. There was no significant change in nuclear Overhauser effects for PME or phosphodiesters (PDEs) between the two field strengths. The T(1) value of PDE was significantly longer at 3 T, although there was no significant change in the T(1) value of PME. There was no significant difference in the mean PME/PDE ratios for either the control or patient groups at both 1.5 and 3.0 T, but there was a small positive mean difference in PME/PDE at 3.0 T on pairwise testing between field strengths (+ 0.05, p < 0.01). There were significant correlations between PME/PDE values at the two magnetic field strengths (r = 0.806, p < 0.001). The underlying broad resonance was reduced at 3.0 T relative to 1.5 T, related to line broadening of the phospholipid bilayer signal. In conclusion, there was an improvement in hepatic (31)P MR signal quality at 3.0 T relative to 1.5 T. Broadly similar hepatic (31)P MR parameters were obtained at 1.5 and 3.0 T. The modest difference noted in the PME/PDE ratio between field strengths for patients with chronic liver disease should inform multicentre study design involving these field strengths.

Heteronuclear decoupling by multiple rotating frame technique

The paper describes the multiple rotating frame technique for designing modulated rf fields, that perform broadband heteronuclear decoupling in solution NMR spectroscopy. The decoupling method presented here is understood by performing a sequence of coordinate transformations, each of which demodulates a component of the rf field to a static component, that progressively averages the chemical shift and the dipolar interaction. We show that by increasing the number of modulations in the decoupling field, the ratio of dispersion in the chemical shift to the strength of the static component of the rf field is successively reduced in the progressive frames. The known decoupling methods like continuous wave decoupling, TPPM, etc., can be viewed as special cases of this method and their performance improves by adding additional modulations in the decoupling field. The technique is also expected to find use in design of broadband excitation, inversion and mixing sequences and broadband experiments in solid state NMR.

13C MRS of occipital and frontal lobes at 3 T using a volume coil for stochastic proton decoupling

Previously, we devised a novel strategy for in vivo 13C MRS using [2-13C]glucose infusion and low-power proton decoupling, and proposed that this strategy could be used to acquire 13C MR spectra from the frontal lobe of the human brain. Here, we demonstrate, for the first time, in vivo 13C MRS of human frontal lobe acquired at 3 T. Because the primary metabolites of [2-13C]glucose can be decoupled using very-low-radiofrequency power, we used a volume coil for proton decoupling in this study. The homogeneous B(1) field of the volume coil was found to significantly enhance the decoupling efficiency of the stochastic decoupling sequence. Detailed specific absorption rates inside the human head were analyzed using the finite difference time domain method to ensure experimental safety. In vivo 13C spectra from the occipital and frontal lobes of the human brain were obtained. At a decoupling power of 30 W (time-averaged power, 2.45 W), the spectra from the occipital lobe showed well-resolved spectral resolution and excellent signal-to-noise ratio. Although frontal lobe 13C spectra were affected by local B(0) field inhomogeneity, we demonstrated that the spectral quality could be improved using post-acquisition data processing. In particular, we showed that the frontal lobe glutamine C5 at 178.5 ppm and aspartate C4 at 178.3 ppm could be spectrally resolved with effective proton decoupling and B(0) field correction. Because of its large spatial coverage, volume coil decoupling provides the potential to acquire 13C MRS from more than one brain region simultaneously.

Evidence for a relationship between body mass and energy metabolism in the human brain

Cerebral energy metabolism has been suggested to have an important function in body weight regulation. We therefore examined whether there is a relationship between body mass and adenosine triphosphate (ATP) metabolism in the human brain. On the basis of our earlier findings indicating a neuroprotective preferential energy supply of the brain, as compared with peripheral muscle on experimentally induced hypoglycemia, we examined whether this physiological response is preserved also in low-weight and obese participants. We included 45 healthy male subjects with a body mass index (BMI) ranging from 17 to 44 kg/m(2). Each participant underwent a hypoglycemic glucose-clamp intervention, and the ATP metabolism, that is, the content of high-energy phosphates phosphocreatine (PCr) and ATP, was measured repeatedly by (31)phosphor magnetic resonance spectroscopy ((31)P-MRS) in the cerebral cortex and skeletal muscle. Results show an inverse correlation between BMI and high-energy phosphate content in the brain (P<0.01), whereas there was no such relationship found between skeletal muscle and BMI. The hypoglycemic clamp intervention did not affect the ATP metabolism in both tissues. Our data show an inverse correlation between BMI and cerebral high-energy phosphate content in healthy humans, suggesting a close relationship between energetic supply of the brain and body weight regulation.

The role of magnetic resonance imaging and spectroscopy in hepatic encephalopathy

Hepatic encephalopathy (HE) is a diverse manifestation of acute and chronic liver failure, ranging from cognitive impairment, only detectable on psychometric evaluation through to confusion, coma and death from cerebral oedema. While there is widespread acceptance of its importance, there is little consensus on how best to diagnose and monitor HE. Clinical descriptions, psychometric testing, electroencephalography and magnetic resonance (MR) imaging (and lately, MR spectroscopy) have all been proposed. MR techniques, in contrast to other modalities, have the benefit of objectivity and of being able to interrogate the brain directly with respect to changes in brain size, function and the metabolic disturbances thought to underlie HE, particularly in the context of astrocyte swelling. Modern clinical MRI scanners with multinuclear MR spectroscopy capabilities and brain mapping software can demonstrate structural and functional cellular changes using volumetric MRI, magnetization transfer MRI, diffusion-weighting MRI, functional MRI with oxygenation measurements and in vivo and in vitro (1)H and (31)P MR spectroscopy. This review describes the relative merits of these techniques and provides guidance on the directions for future research and translation into clinical practice.

In vivo 13C magnetic resonance spectroscopy of human brain on a clinical 3 T scanner using [2-13C]glucose infusion and low-power stochastic decoupling

This study presents the detection of [2-(13)C]glucose metabolism in the carboxylic/amide region in the human brain, and demonstrates that the cerebral metabolism of [2-(13)C]glucose can be studied in human subjects in the presence of severe hardware constraints of widely available 3 T clinical scanners and with low-power stochastic decoupling. In the carboxylic/amide region of human brain, the primary products of (13)C label incorporation from [2-(13)C]glucose into glutamate, glutamine, aspartate, gamma-aminobutyric acid, and N-acetylaspartate were detected. Unlike the commonly used alkanyl region where lipid signals spread over a broad frequency range, the carboxylic carbon signal of lipids was found to be confined to a narrow range centered at 172.5 ppm and present no spectral interference in the absence of lipid suppression. Comparison using phantoms shows that stochastic decoupling is far superior to the commonly used WALTZ sequence at very low decoupling power at 3 T. It was found that glutamine C1 and C5 can be decoupled using stochastic decoupling at 2.2 W, although glutamine protons span a frequency range of approximately 700 Hz. Detailed specific absorption rate analysis was also performed using finite difference time domain numerical simulation.

Exploring the limits of broadband excitation and inversion: II. Rf-power optimized pulses

In [K. Kobzar, T.E. Skinner, N. Khaneja, S.J. Glaser, B. Luy, Exploring the limits of broadband excitation and inversion, J. Magn. Reson. 170 (2004) 236-243], optimal control theory was employed in a systematic study to establish physical limits for the minimum rf-amplitudes required in broadband excitation and inversion pulses. In a number of cases, however, experimental schemes are not limited by rf-amplitudes, but by the overall rf-power applied to a sample. We therefore conducted a second systematic study of excitation and inversion pulses of varying pulse durations with respect to bandwidth and rf-tolerances, but this time using a modified algorithm involving restricted rf-power. The resulting pulses display a variety of pulse shapes with highly modulated rf-amplitudes and generally show better performance than corresponding pulses with identical pulse length and rf-power, but limited rf-amplitude. A detailed description of pulse shapes and their performance is given for the so-called power-BEBOP and power-BIBOP pulses.

Novel strategy for cerebral 13C MRS using very low RF power for proton decoupling

One of the major difficulties of in vivo 13C MRS is the need to decouple the large, one-bond, 1H-13C scalar couplings in order to obtain useful signal-to-noise ratios (SNRs) and spectral resolution at magnetic field strengths that are accessible to clinical studies. In this report a new strategy for in vivo cerebral 13C MRS is proposed. We realized that the turnover kinetics of glutamate (Glu) C5 from exogenous [2-(13)C]glucose (Glc) is identical to that of Glu C4 from exogenous [1-(13)C]Glc. The carboxylic/amide carbons are only coupled to protons via very weak long-range 1H-13C scalar couplings. As such, they can be effectively decoupled at very low RF power. Therefore, decoupling of the large 1H-13C scalar couplings can be avoided by the use of [2-(13)C]Glc. An additional advantage of this strategy is the lack of contamination from subcutaneous lipids because there are no overlapping fat signals in the vicinity of the Glu C5 and glutamine (Gln) C5 peaks. The feasibility of this strategy was demonstrated using 13C MRS on rhesus monkey brains at 4.7T.

Structural Characterization of the Antimicrobial Peptide Pleurocidin from Winter Flounder

Pleurocidin is an antimicrobial peptide that was isolated from the mucus membranes of winter flounder (Pseudopleuronectes americanus) and contributes to the initial stages of defense against bacterial infection. From NMR structural studies with the uniformly (15)N-labeled peptide, a structure of pleurocidin was determined to be in a random coil conformation in aqueous solution whereas it assumes an alpha-helical structure in TFE and in dodecylphosphocholine (DPC) micelles. From (15)N relaxation studies, the helix is a rigid structure in the membrane-mimicking environment. Strong NOESY cross-peaks from the pleurocidin to the aliphatic chain on DPC confirm that pleurocidin is contained within the DPC micelle and not associated with the surface of the micelle. From diffusion studies it was determined that each micelle contains at least two pleurocidin molecules.

Relation between pO2, 31P magnetic resonance spectroscopy parameters and treatment outcome in patients with high-grade soft tissue sarcomas treated with thermoradiotherapy

PURPOSE

In a prior study, the combination of (31)P magnetic resonance spectroscopy (MRS)-based intracellular pH (pHi) and T2 relaxation time was highly predictive of the pathologic complete response (pCR) rate in a small series of patients with soft tissue sarcomas (STSs) treated with thermoradiotherapy. Changes in the magnetic resonance metabolite ratios and pO(2) were related to the pCR rate. Hypoxia also correlated with a greater likelihood for the development of metastases. Because of the limited number of patients in the prior series, we initiated this study to determine whether the prior observations were repeatable and whether (31)P MRS lipid-related resonances were related to a propensity for metastasis.

METHODS AND MATERIALS

Patients with high-grade STSs were enrolled in an institutional review board-approved Phase II thermoradiotherapy trial. All tumors received daily external beam radiotherapy (1.8-2.0 Gy, five times weekly) to a total dose of 30-50 Gy. Hyperthermia followed radiotherapy by <1 h and was given two times weekly. Tumors were resected 4-6 weeks after radiotherapy completion. The MRS/MRI parameters included (31)P metabolite ratios, pHi, and T2 relaxation time. The median pO(2) and hypoxic fraction were determined using pO(2) histography. Comparisons between experimental endpoints and the pCR rate and metastasis-free and overall survival were made.

RESULTS

Of 35 patients, 21 and 28 had reportable pretreatment MRS/MRI and pO(2) data, respectively. The cutpoints for a previously tested receiver operating curve for a pCR were T2 = 100 and pHi = 7.3. In the current series, few tumors fell below the cutpoints so validation was not possible. The phosphodiester (PDE)/inorganic phosphate (Pi) ratio and hypoxic fraction correlated inversely with the pCR rate in the current series (Spearman correlation coefficient -0.51, p = 0.017; odds ratio of percentage of necrosis > or =95% = 0.01 for a 1% increase in the hypoxic fraction; Wald p = 0.036). The pretreatment phosphomonoester (PME)/Pi ratio also correlated inversely with the pCR rate (odds ratio of percentage of necrosis > or =95% = 0.06 for pretreatment PME/Pi ratio >0.8 vs. < or =0.8, Wald p = 0.023). The pretreatment PME/PDE ratio correlated strongly with metastasis-free survival and overall survival (p = 0.012 and hazard ratio = 5.8, and p = 0.038 and hazard ratio = 6.75, respectively).

CONCLUSION

The dual parameter model containing pHi and T2 to predict the pCR in STSs treated with thermoradiotherapy was not verified. However, other parameters were statistically significant, including the PDE/Pi ratio and hypoxic fraction. These relationships may have interfered with our ability to obtain the pCR rate predicted by thermal doses achieved in these patients. The relationship between the PME/PDE ratio and metastasis-free and overall survival was provocative, but requires additional study to verify its predictive capability. Currently, 50% of all STS patients with high-grade tumors develop distant metastasis even when excellent local control is achieved. Parameters that could help select for patients who need adjuvant chemotherapy could have significant clinical benefit.

Theoretical and experimental evaluation of broadband decoupling techniques for in vivo nuclear magnetic resonance spectroscopy

A theoretical and experimental evaluation of existing broadband decoupling methods with respect to their utility for in vivo (1)H-(13)C NMR spectroscopy is presented. Simulations are based on a modified product operator formalism, while an experimental evaluation is performed on in vitro samples and human leg and rat brain in vivo. The performance of broadband decoupling methods was evaluated with respect to the required peak and average RF powers, decoupling bandwidth, decoupling side bands, heteronuclear scalar coupling constant, and sensitivity toward B(2) inhomogeneity. In human applications only the WALTZ and MLEV decoupling methods provide adequate decoupling performance at RF power levels that satisfy the FDA guidelines on local tissue heating. For very low RF power levels (B(2max) < 300 Hz) one should verify empirically whether the experiment will benefit from broadband decoupling. At higher RF power levels acceptable for animal studies additional decoupling techniques become available and provide superior performance. Since the average RF power of adiabatic RF pulses is almost always significantly lower than the peak RF power, it can be stated that for average RF powers suitable for animal studies it is always possible to design an adiabatic decoupling scheme that outperforms all other schemes. B(2) inhomogeneity degrades the decoupling performance of all methods, but the decoupling bandwidths for WALTZ-16 and especially adiabatic methods are still satisfactory for useful in vivo decoupling with a surface coil.

Universal equations for linear adiabatic pulses and characterization of partial adiabaticity

A numerical analysis of the sech/tanh (or hyperbolic secant) and tanh/tan adiabatic inversion pulses provides a set of master equations for each type of pulse that guarantee their optimal implementation over a wide range of practical conditions without needing to further simulate the inversion profiles of the pulses. These simple equations determine the necessary maximum RF amplitude (RF(max)) required for a preselected degree of inversion across a chosen effective bandwidth (bw(eff)) and for a chosen pulse length (T(p)). The two types of pulse function differently: The sech/tanh pulse provides a rectangular inversion profile with bw(eff) being a large fraction of the adiabatic frequency sweep (bwdth), whereas for tanh/tan bw(eff) is < or =bwdth/20. If the quality of inversion is defined as the minimum allowable extent of inversion, iota(bw), at the boundaries of bw(eff), two basic linear equations are found for both types of pulse and these are of the form (RF(max)T(p))(2)=m(1)T(p)bwdth+c(1) and T(p)bwdth=m(3)T(p)bw(eff)+c(3). The different behavior of the two pulses is expressed as different dependencies of the slopes m(n) and intercepts c(n) on iota(bw) and allowances are made for second order effects within these equations. The availability of these master relationships enables a direct comparison of the two types of adiabatic pulse and it is found that tanh/tan requires about half the pulse length of an equivalent sech/tanh pulse and also has the advantage of being less sensitive to the effects of scalar coupling. In contrast sech/tanh delivers about half the total RF power of an equivalent tanh/tan pulse. It is expected that the forms of these two basic linear equations are generally applicable to adiabatic inversion pulses and thus define the concept of "linear adiabaticity." At low values of T(p)bwdth or T(p)bw(eff) the linear equations no longer apply, defining a region of "partial adiabaticity." Normal adiabatic pulses in the middle of this partial region are more efficient in terms of RF(max) or T(p) but are moderately less tolerant to RF inhomogeneity. A class of numerically optimized pulses has recently been developed that specifically trades adiabaticity in an attempt to gain RF(max) or T(p) efficiency. In comparison to normal adiabatic pulses implemented under optimal conditions, these new partially adiabatic pulses show only marginal improvements; they are restricted to single values of T(p)bw(eff), and they are vastly less tolerant to RF inhomogeneity. These comparisons, and direct comparisons between any types of inversion pulse, adiabatic or otherwise, can be made using plots of (RF(max)T(p))(2) or (Total Power) T(p) versus T(p)bw(eff).

Current awareness

In order to keep subscribers up-to-date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of NMR in biomedicine. Each bibliography is divided into 9 sections: 1 Books, Reviews ' Symposia; 2 General; 3 Technology; 4 Brain and Nerves; 5 Neuropathology; 6 Cancer; 7 Cardiac, Vascular and Respiratory Systems; 8 Liver, Kidney and Other Organs; 9 Muscle and Orthopaedic. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.