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Hippocampal Metabolic Alterations in Amyotrophic Lateral Sclerosis: A Magnetic Resonance Spectroscopy Study. Life (Basel) 2023; 13:life13020571. [PMID: 36836928 PMCID: PMC9965919 DOI: 10.3390/life13020571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Magnetic resonance spectroscopy (MRS) in amyotrophic lateral sclerosis (ALS) has been overwhelmingly applied to motor regions to date and our understanding of frontotemporal metabolic signatures is relatively limited. The association between metabolic alterations and cognitive performance in also poorly characterised. MATERIAL AND METHODS In a multimodal, prospective pilot study, the structural, metabolic, and diffusivity profile of the hippocampus was systematically evaluated in patients with ALS. Patients underwent careful clinical and neurocognitive assessments. All patients were non-demented and exhibited normal memory performance. 1H-MRS spectra of the right and left hippocampi were acquired at 3.0T to determine the concentration of a panel of metabolites. The imaging protocol also included high-resolution T1-weighted structural imaging for subsequent hippocampal grey matter (GM) analyses and diffusion tensor imaging (DTI) for the tractographic evaluation of the integrity of the hippocampal perforant pathway zone (PPZ). RESULTS ALS patients exhibited higher hippocampal tNAA, tNAA/tCr and tCho bilaterally, despite the absence of volumetric and PPZ diffusivity differences between the two groups. Furthermore, superior memory performance was associated with higher hippocampal tNAA/tCr bilaterally. Both longer symptom duration and greater functional disability correlated with higher tCho levels. CONCLUSION Hippocampal 1H-MRS may not only contribute to a better academic understanding of extra-motor disease burden in ALS, but given its sensitive correlations with validated clinical metrics, it may serve as practical biomarker for future clinical and clinical trial applications. Neuroimaging protocols in ALS should incorporate MRS in addition to standard structural, functional, and diffusion sequences.
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Cho SY, Kwon S, Shin HY, Kim HR, Kim JH, Park S, Ryu CW, Park JM, Edden RAE, Jahng GH. Treatment evaluation of Kami Guibi-tang on participants with amnestic mild cognitive impairment using magnetic resonance imaging on brain metabolites, gamma-aminobutyric acid, and cerebral blood flow. J Appl Clin Med Phys 2021; 22:151-164. [PMID: 34633758 PMCID: PMC8598148 DOI: 10.1002/acm2.13443] [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: 04/19/2021] [Revised: 09/09/2021] [Accepted: 09/22/2021] [Indexed: 11/11/2022] Open
Abstract
Purpose To evaluate the effectiveness of Kami Guibi‐tang (KGT) in the treatment of mild cognitive impairment (MCI) using magnetic resonance imaging (MRI) on brain metabolites, neurotransmitter, and cerebral blood flow (CBF). Methods We randomly allocated a total of 30 MCI patients to a KGT (N = 16) or a placebo (N = 14) group and performed MRI scans before and after 24 weeks of treatment. The participants underwent brain magnetic resonance spectroscopy and MRI scans to obtain brain metabolites using Point‐RESolved Spectroscopy (PRESS) single‐voxel spectroscopy, gamma‐aminobutyric acid (GABA) neurotransmitter using Mescher–Garwood PRESS, and CBF using pseudocontinuous arterial spin labeling sequences using a 3.0 Tesla MRI system. We analyzed metabolite and neurotransmitter levels and CBF using repeated‐measure analysis of variance to evaluate between‐subject group effect, within‐subject treatment condition effect, and interaction of group by condition (group x condition). Results The GABA+/creatine (Cr) ratio values were not significantly different between the before and after treatment conditions. The glutamate complex/Cr ratio difference before and after treatment was lower in the KGT group than in the placebo group, but was not statistically significant (p = 0.077). The result of region of interest–based CBF measurement showed that CBF values were significantly lower after treatment at Cluster 2 for the KGT group (p = 0.003) and the placebo group (p = 0.011), at hippocampus for the KGT group (p = 0.004) and the placebo group (p = 0.008), and at the fusiform gyrus for the KGT group (p = 0.002). Furthermore, the absolute CBF difference before and after treatment in the fusiform gyrus was significantly lower in the KGT group than in the placebo group (p = 0.024). Conclusions Although a KGT treatment of 24 weeks showed some significant impact on the level of CBF, the Korean version of the mini‐mental state examination score was not significantly different between before and after treatment conditions, indicating that there was no memory function improvement after treatment in amnestic MCI patients. Therefore, further studies should be performed with a relatively larger population and extending the duration of the KGT treatment.
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Affiliation(s)
- Seung-Yeon Cho
- Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sharonkyuhee Kwon
- Department of Biomedical Engineering, Undergraduate School, College of Electronics and Information, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Hee-Yeon Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Ha-Ri Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Hwa Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Soonchan Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Mi Park
- Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Richard A E Edden
- Division of Neuroradiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Izuhara M, Miura S, Otsuki K, Nagahama M, Hayashida M, Hashioka S, Asou H, Kitagaki H, Inagaki M. Magnetic Resonance Spectroscopy in the Ventral Tegmental Area Distinguishes Responders to Suvorexant Prior to Treatment: A 4-Week Prospective Cohort Study. Front Psychiatry 2021; 12:714376. [PMID: 34497544 PMCID: PMC8419448 DOI: 10.3389/fpsyt.2021.714376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The ventral tegmental area (VTA; a dopaminergic nucleus) plays an important role in the sleep-wake regulation system including orexin system. In addition to neuronal activity, there is increasing evidence for an important role of glial cells (i.e., astrocytes and microglia) in these systems. The present study examined the utility of magnetic resonance spectroscopy (MRS) for detecting neural and/or glial changes in the VTA to distinguish responders from non-responders before treatment with the orexin receptor antagonist suvorexant. Methods: A total of 50 patients were screened and 9 patients were excluded. The remaining 41 patients with insomnia who have or not a psychiatric disease who were expected to receive suvorexant treatment were included in this study. We compared MRS signals in the VTA between responders to suvorexant and non-responders before suvorexant use. Based on previous reports, suvorexant responders were defined as patients who improved ≥3 points on the Pittsburgh Sleep Quality Index after 4 weeks of suvorexant use. MRS data included choline (reflects non-specific cell membrane breakdown, including of glial cells) and N-acetylaspartate (a decrease reflects neuronal degeneration). Results: Among 41 examined patients, 20 patients responded to suvorexant and 21 patients did not. By MRS, the choline/creatine and phosphorylcreatine ratio in the VTA was significantly high in non-responders compared with responders (p = 0.039) before suvorexant treatment. There was no difference in the N-acetylaspartate/creatine and phosphorylcreatine ratio (p = 0.297) between the two groups. Conclusions: Changes in glial viability in the VTA might be used to distinguish responders to suvorexant from non-responders before starting treatment. These findings may help with more appropriate selection of patients for suvorexant treatment in clinical practice. Further, we provide novel possible evidence for a relationship between glial changes in the VTA and the orexin system, which may aid in the development of new hypnotics focusing on the VTA and/or glial cells.
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Affiliation(s)
- Muneto Izuhara
- Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Shoko Miura
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Koji Otsuki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Michiharu Nagahama
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Maiko Hayashida
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Sadayuki Hashioka
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hiroya Asou
- Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hajime Kitagaki
- Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
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Structural, Functional, and Metabolic Alterations in Human Cerebrovascular Endothelial Cells during Toxoplasma gondii Infection and Amelioration by Verapamil In Vitro. Microorganisms 2020; 8:microorganisms8091386. [PMID: 32927732 PMCID: PMC7564162 DOI: 10.3390/microorganisms8091386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
Toxoplasma gondii (T. gondii), the causative agent of toxoplasmosis, is a frequent cause of brain infection. Despite its known ability to invade the brain, there is still a dire need to better understand the mechanisms by which this parasite interacts with and crosses the blood–brain barrier (BBB). The present study revealed structural and functional changes associated with infection and replication of T. gondii within human brain microvascular endothelial cells (BMECs) in vitro. T. gondii proliferated within the BMECs and disrupted the integrity of the cerebrovascular barrier through diminishing the cellular viability, disruption of the intercellular junctions and increasing permeability of the BMEC monolayer, as well as altering lipid homeostasis. Proton nuclear magnetic resonance (1H NMR)-based metabolomics combined with multivariate data analysis revealed profiles that can be attributed to infection and variations in the amounts of certain metabolites (e.g., amino acids, fatty acids) in the extracts of infected compared to control cells. Notably, treatment with the Ca2+ channel blocker verapamil rescued BMEC barrier integrity and restricted intracellular replication of the tachyzoites regardless of the time of treatment application (i.e., prior to infection, early- and late-infection). This study provides new insights into the structural and functional changes that accompany T. gondii infection of the BMECs, and sheds light upon the ability of verapamil to inhibit the parasite proliferation and to ameliorate the adverse effects caused by T. gondii infection.
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Konus I, Ozsoy E, Turkcuoglu P, Emre S, Duman F. Evaluation of Metabolite Changes in the Occipital Cortex of Patients with Idiopathic Infantile Nystagmus or Bilateral Ametropic Amblyopia by Magnetic Resonance Spectroscopy. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:406-413. [PMID: 31612650 PMCID: PMC6791948 DOI: 10.3341/kjo.2019.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/18/2019] [Accepted: 06/12/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effects of idiopathic infantile nystagmus (IN) and bilateral ametropic amblyopia on metabolites in the occipital cortex by magnetic resonance spectroscopy. Methods The children included in this prospective study were divided into three groups. Group 1 consisted of 11 patients with idiopathic IN, group 2 consisted of 10 patients with bilateral ametropic amblyopia and group 3 consisted of nine normal children. A single-voxel magnetic resonance spectroscopy examination was performed by placing a region of interest on the occipital cortex of each participant. N-acetyl aspartate (NAA), creatine (Cr) and choline (Cho) concentrations were measured in the occipital cortex. This was followed by calculating and comparing the NAA/Cr and Cho/Cr ratios between the three groups. The Kruskal-Wallis test, Mann-Whitney U-test, and chi-square test were used for statistical analysis. Results There was no statistically significant difference in NAA/Cr ratios between patients with idiopathic IN and normal children, but there was a statistically significant difference between these groups when Cho/Cr ratios were compared; the ratio was higher in the idiopathic IN group. There were no statistically significant differences in NAA/Cr or Cho/Cr ratios between patients with bilateral ametropic amblyopia and normal children. Conclusions Our findings suggest that the neurochemical profile of the occipital cortex is partially affected by idiopathic IN, but not by bilateral ametropic amblyopia.
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Affiliation(s)
- Ismail Konus
- Department of Ophthalmology, Kiziltepe Private Ipekyolu Hospital, Mardin, Turkey
| | - Ercan Ozsoy
- Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Peykan Turkcuoglu
- Department of Ophthalmology, Private Goznuru Eye Hospital, Gaziantep, Turkey
| | - Sinan Emre
- Department of Ophthalmology, Baskent University, Izmir, Turkey
| | - Fulya Duman
- Department of Ophthalmology, Ataturk State Hospital, Antalya, Turkey
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Gao H, Jiang Q, Ji H, Ning J, Li C, Zheng H. Type 1 diabetes induces cognitive dysfunction in rats associated with alterations of the gut microbiome and metabolomes in serum and hippocampus. Biochim Biophys Acta Mol Basis Dis 2019; 1865:165541. [DOI: 10.1016/j.bbadis.2019.165541] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 12/14/2022]
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Xu J, Sun W, Yang L. Association between iron metabolism and cognitive impairment in older non-alcoholic fatty liver disease individuals: A cross-sectional study in patients from a Chinese center. Medicine (Baltimore) 2019; 98:e18189. [PMID: 31770275 PMCID: PMC6890296 DOI: 10.1097/md.0000000000018189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sparse is the research on the relationship between iron metabolism and mild cognitive impairment (MCI) in adults aged over 60 years with non-alcoholic fatty liver disease (NAFLD). The soluble transferrin receptor (sTfR), serum iron (SI), serum ferritin (SF), transferrin (TRF) and hemoglobin (HB) are indicators of iron metabolism.This study examined whether iron metabolism is associated with cognitive impairment in older individuals.A cross-sectional study was held in patients from a Chinese center. Individuals with NAFLD aged over 60 years were included if they did not have excessive alcohol intake and were free of stroke or dementia. Their cognitive function was assessed by the same neurologist. 3.0T H proton magnetic resonance spectroscopy (H-MRS) was performed to evaluate the hippocampus of the participants without contraindication. t test and Chi-square test were used to analyze the data. Binary logistic regression was used for correlation analysis.Fifty four (54%) of participants were diagnosed with MCI by the psychiatrist. MCI was significantly associated with higher sTfR after adjustment of all the covariates (OR = 2.565, 95%CI: 1.334∼4.934; P = .005). No statistically significant associations were observed between MCI and age or blood glucose or choline (Cho) /creatine (Cr) of theright hippocampus head.Increased age and low levels of sTfR and HB were associated with MCI in NAFLD individuals aged over 60 years.
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Affiliation(s)
- Jing Xu
- Department of Geriatric Gastroenterology, The First Affifiliated Hospital of Nanjing Medical University
- Department of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Weihao Sun
- Department of Geriatric Gastroenterology, The First Affifiliated Hospital of Nanjing Medical University
| | - Li Yang
- Department of Geriatrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Perez-Laso C, Cerdan S, Junque C, Gómez Á, Ortega E, Mora M, Avendaño C, Gómez-Gil E, Del Cerro MCR, Guillamon A. Effects of Adult Female Rat Androgenization on Brain Morphology and Metabolomic Profile. Cereb Cortex 2019; 28:2846-2853. [PMID: 29106544 DOI: 10.1093/cercor/bhx163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Indexed: 11/14/2022] Open
Abstract
Androgenization in adult natal women, as in transsexual men (TM), affects brain cortical thickness and the volume of subcortical structures. In order to understand the mechanism underlying these changes we have developed an adult female rat model of androgenization. Magnetic resonance imaging and spectroscopy were used to monitor brain volume changes, white matter microstructure and ex vivo metabolic profiles over 32 days in androgenized and control subjects. Supraphysiological doses of testosterone prevents aging decrease of fractional anisotropy values, decreased general cortical volume and the relative concentrations of glutamine (Gln) and myo-Inositol (mI). An increase in the N-acetylaspartate (NAA)/mI ratio was detected d. Since mI and Gln are astrocyte markers and osmolytes, we suspect that the anabolic effects of testosterone change astrocyte osmolarity so as to extrude Mi and Gln from these cells in order to maintain osmotic homeostasis. This mechanism could explain the brain changes observed in TM and other individuals receiving androgenic anabolic steroids.
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Affiliation(s)
- Carmen Perez-Laso
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Sebastián Cerdan
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Carme Junque
- Departamento de Medicina, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
| | - Ángel Gómez
- Departamento de Psicología Social y de las Organizaciones, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Esperanza Ortega
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Mireia Mora
- Departamento de Endocrinología, Hospital Clínic, Barcelona, Spain
| | - Carlos Avendaño
- Departamento de Anatomía y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Esther Gómez-Gil
- Unidad de Identidad de Género, Departamento de Psiquiatría, Hospital Clìnic, Barcelona, Spain
| | | | - Antonio Guillamon
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
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Shin HY, Kim JH, Jahng GH, Jung WS, Park SU, Ko CN, Park JM. The effectiveness and safety of Kami Guibi-tang for mild cognitive impairment: study protocol of a pilot, randomized, placebo-controlled, double-blind trial. Trials 2019; 20:448. [PMID: 31331367 PMCID: PMC6647292 DOI: 10.1186/s13063-019-3567-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/10/2019] [Indexed: 12/03/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is an intermediate phase between normal aging and dementia. Since a majority of amnestic MCI (aMCI) cases progress to Alzheimer’s disease (AD), it is considered the prodromal stage of AD and, therefore, a treatment target for the prevention of further cognitive decline. However, there is no approved treatment for MCI at present. Kami Guibi-tang (KGT) is a herbal drug used in Korean medicine to treat amnesia, insomnia, loss of appetite, and depression. We will explore the effectiveness and safety of KGT in amnestic MCI in this trial. Methods/design The study will be a single-center, randomized, placebo-controlled, double-blind trial. Eligible participants diagnosed with amnestic MCI will be randomly allocated to a treatment or control group. Participants will take KGT or placebo granules, three times a day, for 24 weeks. The primary outcomes will be changes in Seoul Neuropsychological Screening Battery (SNSB) scores, and magnetic resonance imaging (MRI) measurements including those of brain metabolites, neurotransmitters, and cerebral blood flow. The secondary outcomes will include the safety assessment, measured by changes in blood chemistry, changes in blood protein and cholesterol levels related to AD pathology, and a comparison of MRI changes between the two groups, using age and genotype as covariates. Discussion This study will be the first clinical trial to identify the therapeutic potential of Kami Guibi-tang for amnestic MCI. The findings will provide insight into the feasibility of large-scale trials to gather evidence for KGT as a treatment for MCI. Trial registration Korean Clinical Trial Registry, ID: KCT0002407. Registered on 30 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3567-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hee-Yeon Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.,Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Jeong-Hwa Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.,Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Geon-Ho Jahng
- Department of Radiology, College of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, #892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Woo-Sang Jung
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Seong-Uk Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.,Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Chang-Nam Ko
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.,Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Jung-Mi Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea. .,Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
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Mazón M, Vázquez Costa JF, Ten-Esteve A, Martí-Bonmatí L. Imaging Biomarkers for the Diagnosis and Prognosis of Neurodegenerative Diseases. The Example of Amyotrophic Lateral Sclerosis. Front Neurosci 2018; 12:784. [PMID: 30410433 PMCID: PMC6209630 DOI: 10.3389/fnins.2018.00784] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/10/2018] [Indexed: 12/17/2022] Open
Abstract
The term amyotrophic lateral sclerosis (ALS) comprises a heterogeneous group of fatal neurodegenerative disorders of largely unknown etiology characterized by the upper motor neurons (UMN) and/or lower motor neurons (LMN) degeneration. The development of brain imaging biomarkers is essential to advance in the diagnosis, stratification and monitoring of ALS, both in the clinical practice and clinical trials. In this review, the characteristics of an optimal imaging biomarker and common pitfalls in biomarkers evaluation will be discussed. Moreover, the development and application of the most promising brain magnetic resonance (MR) imaging biomarkers will be reviewed. Finally, the integration of both qualitative and quantitative multimodal brain MR biomarkers in a structured report will be proposed as a support tool for ALS diagnosis and stratification.
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Affiliation(s)
- Miguel Mazón
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
| | - Juan Francisco Vázquez Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Amadeo Ten-Esteve
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
| | - Luis Martí-Bonmatí
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
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Makaryus R, Lee H, Robinson J, Enikolopov G, Benveniste H. Noninvasive Tracking of Anesthesia Neurotoxicity in the Developing Rodent Brain. Anesthesiology 2018; 129:118-130. [PMID: 29688900 PMCID: PMC6008207 DOI: 10.1097/aln.0000000000002229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Potential deleterious effect of multiple anesthesia exposures on the developing brain remains a clinical concern. We hypothesized that multiple neonatal anesthesia exposures are more detrimental to brain maturation than an equivalent single exposure, with more pronounced long-term behavioral consequences. We designed a translational approach using proton magnetic resonance spectroscopy in rodents, noninvasively tracking the neuronal marker N-acetyl-aspartate, in addition to tracking behavioral outcomes. METHODS Trajectories of N-acetyl-aspartate in anesthesia naïve rats (n = 62, postnatal day 5 to 35) were determined using proton magnetic resonance spectroscopy, creating an "N-acetyl-aspartate growth chart." This chart was used to compare the effects of a single 6-h sevoflurane exposure (postnatal day 7) to three 2-h exposures (postnatal days 5, 7, 10). Long-term effects on behavior were separately examined utilizing novel object recognition, open field testing, and Barnes maze tasks. RESULTS Utilizing the N-acetyl-aspartate growth chart, deviations from the normal trajectory were documented in both single and multiple exposure groups, with z-scores (mean ± SD) of -0.80 ± 0.58 (P = 0.003) and -1.87 ± 0.58 (P = 0.002), respectively. Behavioral testing revealed that, in comparison with unexposed and single-exposed, multiple-exposed animals spent the least time with the novel object in novel object recognition (F(2,44) = 4.65, P = 0.015), traveled the least distance in open field testing (F(2,57) = 4.44, P = 0.016), but exhibited no learning deficits in the Barnes maze. CONCLUSIONS Our data demonstrate the feasibility of using the biomarker N-acetyl-aspartate, measured noninvasively using proton magnetic resonance spectroscopy, for longitudinally monitoring anesthesia-induced neurotoxicity. These results also indicate that the neonatal rodent brain is more vulnerable to multiple anesthesia exposures than to a single exposure of the same cumulative duration.
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Affiliation(s)
- Rany Makaryus
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY
| | - Hedok Lee
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT
| | - John Robinson
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | - Grigori Enikolopov
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY
- Center for Developmental Genetics, Stony Brook University, Stony Brook, NY
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT
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Rossi F, Geiszler PC, Meng W, Barron MR, Prior M, Herd-Smith A, Loreto A, Lopez MY, Faas H, Pardon MC, Conforti L. NAD-biosynthetic enzyme NMNAT1 reduces early behavioral impairment in the htau mouse model of tauopathy. Behav Brain Res 2018; 339:140-152. [PMID: 29175372 PMCID: PMC5769520 DOI: 10.1016/j.bbr.2017.11.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/08/2017] [Accepted: 11/22/2017] [Indexed: 11/04/2022]
Abstract
NAD metabolism and the NAD biosynthetic enzymes nicotinamide nucleotide adenylyltransferases (NMNATs) are thought to play a key neuroprotective role in tauopathies, including Alzheimer's disease. Here, we investigated whether modulating the expression of the NMNAT nuclear isoform NMNAT1, which is important for neuronal maintenance, influences the development of behavioral and neuropathological abnormalities in htau mice, which express non-mutant human tau isoforms and represent a model of tauopathy relevant to Alzheimer's disease. Prior to the development of cognitive symptoms, htau mice exhibit tau hyperphosphorylation associated with a selective deficit in food burrowing, a behavior reminiscent to activities of daily living which are impaired early in Alzheimer's disease. We crossed htau mice with Nmnat1 transgenic and knockout mice and tested the resulting offspring until the age of 6 months. We show that overexpression of NMNAT1 ameliorates the early deficit in food burrowing characteristic of htau mice. At 6 months of age, htau mice did not show neurodegenerative changes in both the cortex and hippocampus, and these were not induced by downregulating NMNAT1 levels. Modulating NMNAT1 levels produced a corresponding effect on NMNAT enzymatic activity but did not alter NAD levels in htau mice. Although changes in local NAD levels and subsequent modulation of NAD-dependent enzymes cannot be ruled out, this suggests that the effects seen on behavior may be due to changes in tau phosphorylation. Our results suggest that increasing NMNAT1 levels can slow the progression of symptoms and neuropathological features of tauopathy, but the underlying mechanisms remain to be established.
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Affiliation(s)
- Francesca Rossi
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK; Department of Biomedical Sciences, Cagliari University, Cagliari 09042, Italy
| | - Philippine C Geiszler
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
| | - Weina Meng
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
| | - Matthew R Barron
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
| | - Malcolm Prior
- Department of Biomedical Sciences, Cagliari University, Cagliari 09042, Italy
| | - Anna Herd-Smith
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
| | - Andrea Loreto
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
| | - Maria Yanez Lopez
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Queen's Medical Centre, Medical School, Nottingham NG7 2UH, UK; Faculty of Medicine, Department of Medicine, Imperial College London, Burlington Danes, Hammersmith campus, London W12 0NN, UK
| | - Henryk Faas
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Queen's Medical Centre, Medical School, Nottingham NG7 2UH, UK
| | - Marie-Christine Pardon
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK.
| | - Laura Conforti
- School of Life Sciences, University of Nottingham, Queen's Medical Centre Medical School, Nottingham, NG7 2UH, UK
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Fu Y, Si Z, Li P, Li M, Zhao H, Jiang L, Xing Y, Hong W, Ruan L, Wang JS. Acute psychoactive and toxic effects of D. metel on mice explained by 1H NMR based metabolomics approach. Metab Brain Dis 2017; 32:1295-1309. [PMID: 28584907 DOI: 10.1007/s11011-017-0038-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 05/24/2017] [Indexed: 10/19/2022]
Abstract
Datura metel L. (D. metel) is one well-known folk medical herb with wide application and also the most abused plants all over the world, mainly for spiritual or religious purpose, over-dosing of which often produces poisonous effects. In this study, mice were orally administered with the extract of D. metel once a day at doses for 10 mg/kg and 40 mg/kg for consecutive 4 days, 1H NMR based metabolomics approach aided with histopathological inspection and biochemical assays were used for the first time to study the psychoactive and toxic effects of D. metel. Histopathological inspection revealed obvious hypertrophy of hepatocytes, karyolysis and karyorrhexis in livers as well as distinct nerve cell edema, chromatolysis and lower nuclear density in brains. The increased tissue level of methane dicarboxylic aldehyde (MDA) and superoxide dismutase (SOD), decreased tissue level of glutathione (GSH) along with increased serum level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) suggested brain and liver injury induced by D. metel. Orthogonal signal correction-partial least squares-discriminant analysis (OSC-PLS-DA) of NMR profiles supplemented with correlation network analysis revealed significant altered metabolites and related pathway that contributed to oxidative stress, energy metabolism disturbances, neurotransmitter imbalance and amino acid metabolism disorders.
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Affiliation(s)
- Yonghong Fu
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Zhihong Si
- Cancer Hospital, Chinese Academy of Sciences, 350 Shu Shan Hu Road, Hefei, 230031, People's Republic of China
| | - Pumin Li
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Minghui Li
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - He Zhao
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Lei Jiang
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Yuexiao Xing
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Wei Hong
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Lingyu Ruan
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China
| | - Jun-Song Wang
- Center for Molecular Metabolism, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing, 210094, People's Republic of China.
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de Wilde MC, Vellas B, Girault E, Yavuz AC, Sijben JW. Lower brain and blood nutrient status in Alzheimer's disease: Results from meta-analyses. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2017; 3:416-431. [PMID: 29067348 PMCID: PMC5651428 DOI: 10.1016/j.trci.2017.06.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction Alzheimer's disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Recently, we showed the results of the meta-analyses indicating lower plasma levels of vitamins A, B12, C, E, and folate in AD patients compared with cognitively intact elderly controls (controls). Now, additional and more extensive literature searches were performed selecting studies which compare blood and brain/cerebrospinal fluid (CSF) levels of vitamins, minerals, trace elements, micronutrients, and fatty acids in AD patients versus controls. Methods The literature published after 1980 in Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases was systematically analyzed using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to detect studies meeting the selection criteria. Search terms used are as follows: AD patients, Controls, vitamins, minerals, trace elements, micronutrients, and fatty acids. Random-effects meta-analyses using a linear mixed model with correction for age differences between AD patients and controls were performed when four or more publications were retrieved for a specific nutrient. Results Random-effects meta-analyses of 116 selected publications showed significant lower CSF/brain levels of docosahexaenoic acid (DHA), choline-containing lipids, folate, vitamin B12, vitamin C, and vitamin E. In addition, AD patients showed lower circulatory levels of DHA, eicosapentaenoic acid, choline as phosphatidylcholine, and selenium. Conclusion The current data show that patients with AD have lower CSF/brain availability of DHA, choline, vitamin B12, folate, vitamin C, and vitamin E. Directionally, brain nutrient status appears to parallel the lower circulatory nutrient status; however, more studies are required measuring simultaneously circulatory and central nutrient status to obtain better insight in this observation. The brain is dependent on nutrient supply from the circulation, which in combination with nutrient involvement in AD-pathophysiological mechanisms suggests that patients with AD may have specific nutritional requirements. This hypothesis could be tested using a multicomponent nutritional intervention. First systematic comparison of brain nutrient levels in Alzheimer's disease (AD) patients versus controls. Specific nutrients show lower levels in AD, whereas other nutrients show no difference. Directionally, brain nutrient status seems to parallel blood nutrient status in AD.
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Affiliation(s)
- Martijn C de Wilde
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | - Bruno Vellas
- Gerontopole and UMR INSERM 1027 University Paul Sabatier, Toulouse University Hospital, Toulouse, France
| | - Elodie Girault
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | | | - John W Sijben
- Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
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15
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Lord AR, Li M, Demenescu LR, van den Meer J, Borchardt V, Krause AL, Heinze HJ, Breakspear M, Walter M. Richness in Functional Connectivity Depends on the Neuronal Integrity within the Posterior Cingulate Cortex. Front Neurosci 2017; 11:184. [PMID: 28439224 PMCID: PMC5384321 DOI: 10.3389/fnins.2017.00184] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/20/2017] [Indexed: 12/19/2022] Open
Abstract
The brain's connectivity skeleton-a rich club of strongly interconnected members-was initially shown to exist in human structural networks, but recent evidence suggests a functional counterpart. This rich club typically includes key regions (or hubs) from multiple canonical networks, reducing the cost of inter-network communication. The posterior cingulate cortex (PCC), a hub node embedded within the default mode network, is known to facilitate communication between brain networks and is a key member of the "rich club." Here, we assessed how metabolic signatures of neuronal integrity and cortical thickness influence the global extent of a functional rich club as measured using the functional rich club coefficient (fRCC). Rich club estimation was performed on functional connectivity of resting state brain signals acquired at 3T in 48 healthy adult subjects. Magnetic resonance spectroscopy was measured in the same session using a point resolved spectroscopy sequence. We confirmed convergence of functional rich club with a previously established structural rich club. N-acetyl aspartate (NAA) in the PCC is significantly correlated with age (p = 0.001), while the rich club coefficient showed no effect of age (p = 0.106). In addition, we found a significant quadratic relationship between fRCC and NAA concentration in PCC (p = 0.009). Furthermore, cortical thinning in the PCC was correlated with a reduced rich club coefficient after accounting for age and NAA. In conclusion, we found that the fRCC is related to a marker of neuronal integrity in a key region of the cingulate cortex. Furthermore, cortical thinning in the same area was observed, suggesting that both cortical thinning and neuronal integrity in the hub regions influence functional integration of at a whole brain level.
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Affiliation(s)
- Anton R Lord
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany.,Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany.,QIMR Berghofer Medical Research InstituteBrisbane, QLD, Australia
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Neurology, Otto-von-Guericke UniversityMagdeburg, Germany
| | - Liliana R Demenescu
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany.,Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany
| | - Johan van den Meer
- Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Neurology, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Cognition and Emotion, Netherlands Institute for Neuroscience, An Institute of the Royal Academy of Arts and SciencesAmsterdam, Netherlands
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany
| | - Anna Linda Krause
- Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke UniversityMagdeburg, Germany
| | - Hans-Jochen Heinze
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany.,Department of Neurology, Otto-von-Guericke UniversityMagdeburg, Germany.,Center of Behavioral Brain Sciences, Otto-von-Guericke UniversityMagdeburg, Germany
| | - Michael Breakspear
- QIMR Berghofer Medical Research InstituteBrisbane, QLD, Australia.,Metro North Mental Health Service, Royal Brisbane and Women's HospitalBrisbane, QLD, Australia
| | - Martin Walter
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany.,Clinical Affective Neuroimaging Laboratory, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke UniversityMagdeburg, Germany.,Center of Behavioral Brain Sciences, Otto-von-Guericke UniversityMagdeburg, Germany.,Department of Psychiatry, Eberhad Karls University TuebingenTuebingen, Germany
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16
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Abstract
BACKGROUND A wealth of data shows neuronal demise after general anesthesia in the very young rodent brain. Herein, the authors apply proton magnetic resonance spectroscopy (1HMRS), testing the hypothesis that neurotoxic exposure during peak synaptogenesis can be tracked via changes in neuronal metabolites. METHODS 1HMRS spectra were acquired in the brain (thalamus) of neonatal rat pups 24 and 48 h after sevoflurane exposure on postnatal day (PND) 7 and 15 and in unexposed, sham controls. A repeated measure ANOVA was performed to examine whether changes in metabolites were different between exposed and unexposed groups. Sevoflurane-induced neurotoxicity on PND7 was confirmed by immunohistochemistry. RESULTS In unexposed PND7 pups (N = 21), concentration of N-acetylaspartate (NAA; [NAA]) increased by 16% from PND8 to PND9, whereas in exposed PND7 pups (N = 19), [NAA] did not change and concentration of glycerophosphorylcholine and phosphorylcholine ([GPC + PCh]) decreased by 25%. In PND15 rats, [NAA] increased from PND16 to PND17 for both the exposed (N = 14) and the unexposed (N = 16) groups. Two-way ANOVA for PND7 pups demonstrated that changes over time observed in [NAA] (P = 0.031) and [GPC + PCh] (P = 0.024) were different between those two groups. CONCLUSIONS The authors demonstrated that normal [NAA] increase from PND8 to PND9 was impeded in sevoflurane-exposed rats when exposed at PND7; however, not impeded when exposed on PND15. Furthermore, the authors showed that noninvasive 1HMRS is sufficiently sensitive to detect subtle differences in developmental time trajectory of [NAA]. This is potentially clinically relevant because 1HMRS can be applied across species and may be useful in providing evidence of neurotoxicity in the human neonatal brain.
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Chiò A, Pagani M, Agosta F, Calvo A, Cistaro A, Filippi M. Neuroimaging in amyotrophic lateral sclerosis: insights into structural and functional changes. Lancet Neurol 2014; 13:1228-40. [PMID: 25453462 DOI: 10.1016/s1474-4422(14)70167-x] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the past two decades, structural and functional neuroimaging findings have greatly modified longstanding notions regarding the pathophysiology of amyotrophic lateral sclerosis (ALS). Neuroimaging studies have shown that anatomical and functional lesions spread beyond precentral cortices and corticospinal tracts, to include the corpus callosum; frontal, sensory, and premotor cortices; thalamus; and midbrain. Both MRI and PET studies have shown early and diffuse loss of inhibitory cortical interneurons in the motor cortex (increased levels of functional connectivity and loss of GABAergic neurons, respectively) and diffuse gliosis in white-matter tracts. In ALS endophenotypes, neuroimaging has also shown a diverse spreading of lesions and a dissimilar impairment of functional and structural connections. A possible role of PET in the diagnosis of ALS has recently been proposed. However, most neuroimaging studies have pitfalls, such as a small number and poor clinical characterisation of patients, absence of adequate controls, and scarcity of longitudinal assessments. Studies involving international collaborations, standardised assessments, and large patient cohorts will overcome these shortcomings and provide further insight into the pathogenesis of ALS.
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Affiliation(s)
- Adriano Chiò
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy; Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Calvo
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy
| | - Angelina Cistaro
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy; Positron Emission Tomography Center IRMET S.p.A, Euromedic Inc, Torino, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Side of limb-onset predicts laterality of gray matter loss in amyotrophic lateral sclerosis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:473250. [PMID: 25093168 PMCID: PMC4100370 DOI: 10.1155/2014/473250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/03/2014] [Indexed: 11/17/2022]
Abstract
Conflicting findings have been reported regarding the lateralized brain abnormality in patients with amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the probable lateralization of gray matter (GM) atrophy in ALS patients. We focused on the relationship between the asymmetry in decreased GM volume and the side of disease onset in patients with limb-onset. Structural imaging evaluation of normalized atrophy (SIENAX) and voxel-based morphometry (VBM) were used to assess differences in global and local brain regions in patients with heterogeneous body onset and subgroups with different side of limb-onset. We found global brain atrophy and GM losses in the frontal and parietal areas in each patient group as well as left predominant GM losses in the total cohort. The intriguing findings in subgroup analyses demonstrated that the motor cortex in the contralateral hemisphere of the initially involved limb was most affected. We also found that regional brain atrophy was related to disease progression rate. Our observations suggested that side of limb-onset can predict laterality of GM loss in ALS patients and disease progression correlates with the extent of cortical abnormality.
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Lessons of ALS imaging: Pitfalls and future directions - A critical review. NEUROIMAGE-CLINICAL 2014; 4:436-43. [PMID: 24624329 PMCID: PMC3950559 DOI: 10.1016/j.nicl.2014.02.011] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/23/2014] [Accepted: 02/23/2014] [Indexed: 12/19/2022]
Abstract
Background While neuroimaging in ALS has gained unprecedented momentum in recent years, little progress has been made in the development of viable diagnostic, prognostic and monitoring markers. Objectives To identify and discuss the common pitfalls in ALS imaging studies and to reflect on optimal study designs based on pioneering studies. Methods A “PubMed”-based literature search on ALS was performed based on neuroimaging-related keywords. Study limitations were systematically reviewed and classified so that stereotypical trends could be identified. Results Common shortcomings, such as relatively small sample sizes, statistically underpowered study designs, lack of disease controls, poorly characterised patient cohorts and a large number of conflicting studies, remain a significant challenge to the field. Imaging data of ALS continue to be interpreted at a group-level, as opposed to meaningful individual-patient inferences. Conclusions A systematic, critical review of ALS imaging has identified stereotypical shortcomings, the lessons of which should be considered in the design of future prospective MRI studies. At a time when large multicentre studies are underway a candid discussion of these factors is particularly timely. Stereotypical shortcomings can be identified in ALS neuroimaging studies. A systematic discussion of ALS study limitations is particularly timely. Individual patient data meta-analyses and multicentre studies are urgently required. The gaps identified in ALS imaging indicate exciting research opportunities.
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Key Words
- AD, axial diffusivity
- Amyotrophic lateral sclerosis
- Biomarker
- C9orf72, chromosome 9 open reading frame 72
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- MD, mean diffusivity
- MEG, magnetoencephalography
- MRI
- MRS, magnetic resonance spectroscopy
- MUNE, motor unit number estimation
- PET
- PET, positron emission tomography
- PNS, peripheral nervous system
- RD, radial diffusivity
- ROI, region of interest
- SPECT, single photon emission computed tomography
- Spectroscopy
- TMS, transcranial magnetic stimulation
- VBM, voxel-based morphometry
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An
1
H‐MRS framework predicts the onset of Alzheimer's disease symptoms in
PSEN1
mutation carriers. Alzheimers Dement 2013; 10:552-61. [DOI: 10.1016/j.jalz.2013.08.282] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 08/07/2013] [Accepted: 08/28/2013] [Indexed: 12/30/2022]
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21
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Jansen D, Zerbi V, Arnoldussen IAC, Wiesmann M, Rijpma A, Fang XT, Dederen PJ, Mutsaers MPC, Broersen LM, Lütjohann D, Miller M, Joosten LAB, Heerschap A, Kiliaan AJ. Effects of specific multi-nutrient enriched diets on cerebral metabolism, cognition and neuropathology in AβPPswe-PS1dE9 mice. PLoS One 2013; 8:e75393. [PMID: 24086523 PMCID: PMC3782450 DOI: 10.1371/journal.pone.0075393] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 08/12/2013] [Indexed: 11/30/2022] Open
Abstract
Recent studies have focused on the use of multi-nutrient dietary interventions in search of alternatives for the treatment and prevention of Alzheimer's disease (AD). In this study we investigated to which extent long-term consumption of two specific multi-nutrient diets can modulate AD-related etiopathogenic mechanisms and behavior in 11-12-month-old AβPPswe-PS1dE9 mice. Starting from 2 months of age, male AβPP-PS1 mice and wild-type littermates were fed either a control diet, the DHA+EPA+UMP (DEU) diet enriched with uridine monophosphate (UMP) and the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), or the Fortasyn® Connect (FC) diet enriched with the DEU diet plus phospholipids, choline, folic acid, vitamins and antioxidants. We performed behavioral testing, proton magnetic resonance spectroscopy, immunohistochemistry, biochemical analyses and quantitative real-time PCR to gain a better understanding of the potential mechanisms by which these multi-nutrient diets exert protective properties against AD. Our results show that both diets were equally effective in changing brain fatty acid and cholesterol profiles. However, the diets differentially affected AD-related pathologies and behavioral measures, suggesting that the effectiveness of specific nutrients may depend on the dietary context in which they are provided. The FC diet was more effective than the DEU diet in counteracting neurodegenerative aspects of AD and enhancing processes involved in neuronal maintenance and repair. Both diets elevated interleukin-1β mRNA levels in AβPP-PS1 and wild-type mice. The FC diet additionally restored neurogenesis in AβPP-PS1 mice, decreased hippocampal levels of unbound choline-containing compounds in wild-type and AβPP-PS1 animals, suggesting diminished membrane turnover, and decreased anxiety-related behavior in the open field behavior. In conclusion, the current data indicate that specific multi-nutrient diets can influence AD-related etiopathogenic processes. Intervention with the FC diet might be of interest for several other neurodegenerative and neurological disorders.
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Affiliation(s)
- Diane Jansen
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Valerio Zerbi
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Ilse A. C. Arnoldussen
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Maximilian Wiesmann
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Anne Rijpma
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Xiaotian T. Fang
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Pieter J. Dederen
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Martina P. C. Mutsaers
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Laus M. Broersen
- Nutricia Advanced Medical Nutrition, Danone Research, Centre for Specialised Nutrition, Wageningen, The Netherlands
| | - Dieter Lütjohann
- Institute for Clinical Chemistry and Clinical Pharmacology, University Clinics Bonn, Bonn, Germany
| | - Malgorzata Miller
- Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity, Nijmegen, The Netherlands
| | - Leo A. B. Joosten
- Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity, Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Amanda J. Kiliaan
- Department of Anatomy, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- * E-mail:
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Magnetic resonance spectroscopy in mild cognitive impairment: systematic review and meta-analysis. Neurosci Biobehav Rev 2013; 37:2571-86. [PMID: 23969177 DOI: 10.1016/j.neubiorev.2013.08.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 07/17/2013] [Accepted: 08/11/2013] [Indexed: 01/28/2023]
Abstract
Research using proton magnetic resonance spectroscopy (MRS) can potentially elucidate metabolite changes representing early degeneration in Mild Cognitive Impairment (MCI), an early stage of dementia. We integrated the published literature using meta-analysis to identify patterns of metabolite changes in MCI. 29 MRS studies (with a total of 607 MCI patients and 862 healthy controls) were classified according to brain regions. Hedges' g was used as effect size in a random effects model. N-Acetyl Aspartate (NAA) measures were consistently reduced in posterior cingulate (PC), hippocampus, and the paratrigonal white matter (PWM). Creatine (Cr) concentration was reduced in the hippocampus and PWM. Choline (Cho) concentration was reduced in the hippocampus while Cho/Cr ratio was raised in the PC. Myo-inositol (mI) concentration was raised in the PC and mI/Cr ratio was raised in the hippocampus. NAA/mI ratio was reduced in the PC. NAA may be the most reliable marker of brain dysfunction in MCI though mI, Cho, and Cr may also contribute towards this.
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Guilarte TR. Manganese neurotoxicity: new perspectives from behavioral, neuroimaging, and neuropathological studies in humans and non-human primates. Front Aging Neurosci 2013; 5:23. [PMID: 23805100 PMCID: PMC3690350 DOI: 10.3389/fnagi.2013.00023] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 06/05/2013] [Indexed: 01/10/2023] Open
Abstract
Manganese (Mn) is an essential metal and has important physiological functions for human health. However, exposure to excess levels of Mn in occupational settings or from environmental sources has been associated with a neurological syndrome comprising cognitive deficits, neuropsychological abnormalities and parkinsonism. Historically, studies on the effects of Mn in humans and experimental animals have been concerned with effects on the basal ganglia and the dopaminergic system as it relates to movement abnormalities. However, emerging studies are beginning to provide significant evidence of Mn effects on cortical structures and cognitive function at lower levels than previously recognized. This review advances new knowledge of putative mechanisms by which exposure to excess levels of Mn alters neurobiological systems and produces neurological deficits not only in the basal ganglia but also in the cerebral cortex. The emerging evidence suggests that working memory is significantly affected by chronic Mn exposure and this may be mediated by alterations in brain structures associated with the working memory network including the caudate nucleus in the striatum, frontal cortex and parietal cortex. Dysregulation of the dopaminergic system may play an important role in both the movement abnormalities as well as the neuropsychiatric and cognitive function deficits that have been described in humans and non-human primates exposed to Mn.
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Affiliation(s)
- Tomás R Guilarte
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University New York, NY, USA
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Amyotrophic Lateral Sclerosis and Metabolomics: Clinical Implication and Therapeutic Approach. J Biomark 2013; 2013:538765. [PMID: 26317018 PMCID: PMC4437352 DOI: 10.1155/2013/538765] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 02/02/2013] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is one of the most common motor neurodegenerative disorders, primarily affecting upper and lower motor neurons in the brain, brainstem, and spinal cord, resulting in paralysis due to muscle weakness and atrophy. The majority of patients die within 3–5 years of symptom onset as a consequence of respiratory failure. Due to relatively fast progression of the disease, early diagnosis is essential. Metabolomics offer a unique opportunity to understand the spatiotemporal metabolic crosstalks through the assessment of body fluids and tissue. So far, one of the most challenging issues related to ALS is to understand the variation of metabolites in body fluids and CNS with the progression of disease. In this paper we will review the changes in metabolic profile in response to disease progression condition and also see the therapeutic implication of various drugs in ALS patients.
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Verma G, Woo JH, Chawla S, Wang S, Sheriff S, Elman LB, McCluskey LF, Grossman M, Melhem ER, Maudsley AA, Poptani H. Whole-brain analysis of amyotrophic lateral sclerosis by using echo-planar spectroscopic imaging. Radiology 2013; 267:851-7. [PMID: 23360740 DOI: 10.1148/radiol.13121148] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To detect regional metabolic differences in amyotrophic lateral sclerosis (ALS) with whole-brain echo-planar spectroscopic imaging. MATERIALS AND METHODS Sixteen patients with ALS (nine men, seven women; mean age, 56.6 years), five persons suspected of having ALS (four men, one woman; mean age, 62.6 years), and 10 healthy control subjects (five men, five women; mean age, 56.1 years) underwent echo-planar spectroscopic imaging after providing informed consent. The study was approved by the institutional review board and complied with HIPAA. Data were analyzed with the Metabolic Imaging and Data Analysis System software, and processed metabolite maps were coregistered and normalized to a standard brain template. Metabolite maps of creatine (Cr), choline (Cho), and N-acetylaspartate (NAA) were segmented into 81 regions with Automated Anatomical Labeling software to measure metabolic changes throughout the brains of patients with ALS. Statistical analysis involved an unpaired, uncorrected, two-sided Student t test. RESULTS The NAA/Cho ratio across six regions was significantly lower by a mean of 23% (P ≤ .01) in patients with ALS than in control subjects. These regions included the caudate, lingual gyrus, supramarginal gyrus, and right and left superior and right inferior occipital lobes. The NAA/Cr ratio was significantly lower (P ≤ .01) in eight regions in the patient group, by a mean of 16%. These included the caudate, cuneus, frontal inferior operculum, Heschl gyrus, precentral gyrus, rolandic operculum, and superior and inferior occipital lobes. The Cho/Cr ratio did not significantly differ in any region between patient and control groups. CONCLUSION Whole-brain echo-planar spectroscopic imaging permits detection of regional metabolic abnormalities in ALS, including not only the motor cortex but also several other regions implicated in ALS pathophysiologic findings.
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Affiliation(s)
- Gaurav Verma
- Department of Radiology, Hospital of the University of Pennsylvania, B6 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104, USA
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Verina T, Schneider JS, Guilarte TR. Manganese exposure induces α-synuclein aggregation in the frontal cortex of non-human primates. Toxicol Lett 2012; 217:177-83. [PMID: 23262390 DOI: 10.1016/j.toxlet.2012.12.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 12/07/2012] [Accepted: 12/08/2012] [Indexed: 01/01/2023]
Abstract
Aggregation of α-synuclein (α-syn) in the brain is a defining pathological feature of neurodegenerative disorders classified as synucleinopathies. They include Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Occupational and environmental exposure to manganese (Mn) is associated with a neurological syndrome consisting of psychiatric symptoms, cognitive impairment and parkinsonism. In this study, we examined α-syn immunoreactivity in the frontal cortex of Cynomolgus macaques as part of a multidisciplinary assessment of the neurological effects produced by exposure to moderate levels of Mn. We found increased α-syn-positive cells in the gray matter of Mn-exposed animals, typically observed in pyramidal and medium-sized neurons in deep cortical layers. Some of these neurons displayed loss of Nissl staining with α-syn-positive spherical aggregates. In the white matter we also observed α-syn-positive glial cells and in some cases α-syn-positive neurites. These findings suggest that Mn exposure promotes α-syn aggregation in neuronal and glial cells that may ultimately lead to degeneration in the frontal cortex gray and white matter. To our knowledge, this is the first report of Mn-induced neuronal and glial cell α-syn accumulation and aggregation in the frontal cortex of non-human primates.
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Affiliation(s)
- Tatyana Verina
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Turner MR, Agosta F, Bede P, Govind V, Lulé D, Verstraete E. Neuroimaging in amyotrophic lateral sclerosis. Biomark Med 2012; 6:319-37. [PMID: 22731907 DOI: 10.2217/bmm.12.26] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The catastrophic system failure in amyotrophic lateral sclerosis is characterized by progressive neurodegeneration within the corticospinal tracts, brainstem nuclei and spinal cord anterior horns, with an extra-motor pathology that has overlap with frontotemporal dementia. The development of computed tomography and, even more so, MRI has brought insights into neurological disease, previously only available through post-mortem study. Although largely research-based, radionuclide imaging has continued to provide mechanistic insights into neurodegenerative disorders. The evolution of MRI to use advanced sequences highly sensitive to cortical and white matter structure, parenchymal metabolites and blood flow, many of which are now applicable to the spinal cord as well as the brain, make it a uniquely valuable tool for the study of a multisystem disorder such as amyotrophic lateral sclerosis. This comprehensive review considers the full range of neuroimaging techniques applied to amyotrophic lateral sclerosis over the last 25 years, the biomarkers they have revealed and future developments.
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Affiliation(s)
- Martin R Turner
- Nuffield Department of Clinical Neurosciences, Oxford University, UK.
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Preclinical (1)H-MRS neurochemical profiling in neurological and psychiatric disorders. Bioanalysis 2012; 4:1787-804. [PMID: 22877223 DOI: 10.4155/bio.12.129] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The ongoing development of animal models of neurological and psychiatric disorders in combination with the development of advanced nuclear magnetic resonance (NMR) techniques and instrumentation has led to increased use of in vivo proton NMR spectroscopy ((1)H-MRS) for neurochemical analyses. (1)H-MRS is one of only a few analytical methods that can assay in vivo and longitudinal neurochemical changes associated with neurological and psychiatric diseases, with the added advantage of being a technique that can be utilized in both preclinical and clinical studies. In this review, recent progress in the use of (1)H-MRS to investigate animal models of neurological and psychiatric disorders is summarized with examples from the literature and our own work.
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Quinn C, Elman L, McCluskey L, Hoskins K, Karam C, Woo JH, Poptani H, Wang S, Chawla S, Kasner SE, Grossman M. Frontal lobe abnormalities on MRS correlate with poor letter fluency in ALS. Neurology 2012; 79:583-8. [PMID: 22843269 DOI: 10.1212/wnl.0b013e3182635720] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine whether frontal lobe abnormalities on magnetic resonance spectroscopy (MRS) in amyotrophic lateral sclerosis (ALS) correlate with poor letter fluency (LF). METHODS Twenty-five patients with ALS (20 with definite, probable, or possible ALS and 5 with progressive muscular atrophy) performed an LF task, involving F word generation in 1 minute, and underwent MRS. Comparisons were made between patients with ALS with impaired LF and unimpaired LF based on an empirically derived cutoff score. A Spearman correlation was performed between the patient's N-acetyl acetate/creatinine-phosphocreatinine ratio (NAA/Cr) and the number of F words generated. RESULTS LF was impaired in 50% of patients with ALS. Patients with impaired LF had reduced NAA/Cr in the DLPFC compared with those with unimpaired LF (p = 0.007). There was a significant correlation between LF and NAA/Cr in the DLPFC (r = 0.51, p = 0.0009). The ALS Functional Rating Scale score, clinical region of motor onset, and disease category had no effect on LF or NAA/Cr in the DLPFC. CONCLUSIONS A reduced NAA/Cr in the DLPFC of patients with ALS is a marker of neuronal dysfunction and correlates with impaired performance on a clinical measure of executive function.
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Affiliation(s)
- Colin Quinn
- Department of Neurology, University of Pennsylvania, PA, USA.
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Guilarte TR, Opler M, Pletnikov M. Is lead exposure in early life an environmental risk factor for Schizophrenia? Neurobiological connections and testable hypotheses. Neurotoxicology 2012; 33:560-74. [PMID: 22178136 PMCID: PMC3647679 DOI: 10.1016/j.neuro.2011.11.008] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 11/30/2011] [Accepted: 11/30/2011] [Indexed: 02/06/2023]
Abstract
Schizophrenia is a devastating neuropsychiatric disorder of unknown etiology. There is general agreement in the scientific community that schizophrenia is a disorder of neurodevelopmental origin in which both genes and environmental factors come together to produce a schizophrenia phenotype later in life. The challenging questions have been which genes and what environmental factors? Although there is evidence that different chromosome loci and several genes impart susceptibility for schizophrenia; and epidemiological studies point to broad aspects of the environment, only recently there has been an interest in studying gene × environment interactions. Recent evidence of a potential association between prenatal lead (Pb(2+)) exposure and schizophrenia precipitated the search for plausible neurobiological connections. The most promising connection is that in schizophrenia and in developmental Pb(2+) exposure there is strong evidence for hypoactivity of the N-methyl-d-aspartate (NMDA) subtype of excitatory amino acid receptors as an underlying neurobiological mechanism in both conditions. A hypofunction of the NMDA receptor (NMDAR) complex during critical periods of development may alter neurobiological processes that are essential for brain growth and wiring, synaptic plasticity and cognitive and behavioral outcomes associated with schizophrenia. We also describe on-going proof of concept gene-environment interaction studies of early life Pb(2+) exposure in mice expressing the human mutant form of the disrupted in schizophrenia 1 (DISC-1) gene, a gene that is strongly associated with schizophrenia and allied mental disorders.
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Affiliation(s)
- Tomás R Guilarte
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, United States.
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Ozsoy E, Doganay S, Dogan M, Alkan A, Firat PG. Evaluation of metabolite changes in visual cortex in diabetic retinopathy by MR-spectroscopy. J Diabetes Complications 2012; 26:241-5. [PMID: 22512974 DOI: 10.1016/j.jdiacomp.2012.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate metabolite changes in the visual cortex of diabetic patients with nonproliferative or proliferative diabetic retinopathy by Magnetic Resonance Spectroscopy (MRS). MATERIALS AND METHODS 15 normal subjects (group 1), 15 patients with diabetes who did not have diabetic retinopathy (group 2), 15 patients with nonproliferative diabetic retinopathy (NPDR) (group 3), and 15 patients with proliferative diabetic retinopathy (PDR) (group 4) were included in the study. Furthermore, diabetic patients were divided into two groups according to HbA1c levels (Group A: 20 patients, HbA1c <8%; Group B: 20 patients, HbA1c >8%). In all cases' left visual cortex, amounts of N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr) were measured by MRS. NAA/Cr, Cho/Cr, and NAA/Cho ratios were calculated. Furthermore, all cases' complete blood count (CBC) and biochemical parameters were evaluated. RESULTS There was no statistically significant difference for NAA/Cr, Cho/Cr, and NAA/Cho ratios between groups 1, 2, 3, and 4 (P>0.05). However there was a statistically significant difference for NAA/Cr and NAA/Cho ratios between groups A and B (P<0.05). There was no statistically significant difference for Cho/Cr ratio between groups A and B (P>0.05). CONCLUSION Although NAA/Cr and NAA/Cho ratios decrease in the visual cortex while diabetic retinopathy progresses, these decreases are not statistically significant. While HbA1c levels increase, the NAA concentration decreases in the visual cortex which indicates neuronal loss. The metabolite changes in the visual cortex are associated with acute events rather than chronic.
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Govind V, Sharma KR, Maudsley AA, Arheart KL, Saigal G, Sheriff S. Comprehensive evaluation of corticospinal tract metabolites in amyotrophic lateral sclerosis using whole-brain 1H MR spectroscopy. PLoS One 2012; 7:e35607. [PMID: 22539984 PMCID: PMC3335096 DOI: 10.1371/journal.pone.0035607] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Accepted: 03/20/2012] [Indexed: 11/19/2022] Open
Abstract
Changes in the distribution of the proton magnetic resonance spectroscopy (MRS) observed metabolites N-acetyl aspartate (NAA), total-choline (Cho), and total-creatine (Cre) in the entire intracranial corticospinal tract (CST) including the primary motor cortex were evaluated in patients with amyotrophic lateral sclerosis (ALS). The study included 38 sporadic definite-ALS subjects and 70 age-matched control subjects. All received whole-brain MR imaging and spectroscopic imaging scans at 3T and clinical neurological assessments including percentage maximum forced vital capacity (FVC) and upper motor neuron (UMN) function. Differences in each individual metabolite and its ratio distributions were evaluated in the entire intracranial CST and in five segments along the length of the CST (at the levels of precentral gyrus (PCG), centrum semiovale (CS), corona radiata (CR), posterior limb of internal capsule (PLIC) and cerebral peduncle (CP)). Major findings included significantly decreased NAA and increased Cho and Cho/NAA in the entire intracranial CST, with the largest differences for Cho/NAA in all the groups. Significant correlations between Cho/NAA in the entire intracranial CST and the right finger tap rate were noted. Of the ten bilateral CST segments, significantly decreased NAA in 4 segments, increased Cho in 5 segments and increased Cho/NAA in all the segments were found. Significant left versus right CST asymmetries were found only in ALS for Cho/NAA in the CS. Among the significant correlations found between Cho/NAA and the clinical assessments included the left-PCG versus FVC and right finger tap rate, left -CR versus FVC and right finger tap rate, and left PLIC versus FVC and right foot tap rate. These results demonstrate that a significant and bilaterally asymmetric alteration of metabolites occurs along the length of the entire intracranial CST in ALS, and the MRS metrics in the segments correlate with measures of disease severity and UMN function.
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Affiliation(s)
- Varan Govind
- Department of Radiology, University of Miami School of Medicine, Miami, Florida, United States of America.
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Metabolic alterations in the amygdala in borderline personality disorder: a proton magnetic resonance spectroscopy study. Biol Psychiatry 2010; 67:399-405. [PMID: 19931853 DOI: 10.1016/j.biopsych.2009.09.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 09/16/2009] [Accepted: 09/26/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Emotional dysfunction in a frontolimbic network has been implicated in the pathophysiology of borderline personality disorder (BPD). The amygdala is a key region of the limbic system and plays an important role in impulsivity, affect regulation, and emotional information processing and thus is likely related to BPD symptoms. Alterations of the metabolism in the amygdala might be of interest for understanding the pathophysiology of BPD. However, the amygdala is a difficult region from which to acquire magnetic resonance spectra. We implemented a method for proton magnetic resonance spectroscopy ((1)H MRS) at 3.0 T in which we acquire data within only the small amygdala. The purpose of this study was to determine alterations of the metabolism in the amygdala in BPD patients. METHODS Twenty-one unmedicated BPD patients and 20 age-matched healthy control participants underwent (1)H MRS to determine neurometabolite concentrations in the left amygdala. All participants underwent psychometric assessments. RESULTS Significantly reduced total N-acetylaspartate (tNAA) and total creatine (tCr) concentrations in the left amygdala of patients with BPD were found. BPD patients with comorbid posttraumatic stress disorder (PTSD) showed lower levels of tCr compared with BPD patients without PTSD and healthy control subjects. No significant correlations between neurochemical concentrations and psychometric measures were found. CONCLUSIONS Decreased tNAA and tCr might indicate disturbed affect regulation and emotional information processing in the amygdala of BPD patients. These findings are consistent with many functional and structural neuroimaging studies and may help to explain the greater emotional reactivity of BPD patients.
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Cerebral metabolic changes in neurologically presymptomatic patients undergoing haemodialysis: in vivo proton MR spectroscopic findings. Eur Radiol 2009; 20:1502-7. [PMID: 19997847 DOI: 10.1007/s00330-009-1673-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 09/09/2009] [Accepted: 10/10/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To prospectively investigate and detect early cerebral metabolic changes in patients with end-stage renal disease (ESRD) by using in vivo proton MR spectroscopy (MRS). METHODS We enrolled 32 patients with ESRD and 32 healthy controls between the ages of 26 and 50 years. Short echo time single-voxel proton MRS was acquired from volumes of interest (VOIs) located in the frontal grey and white matter, temporal white matter and basal ganglia. The choline/phospatidylcholine (Cho), myo-inositol (mI), N-acetylaspartate (NAA) and total creatine (tCr) peaks were measured and the metabolic ratios with respect to tCr were calculated. RESULTS In the ESRD group, significant elevations of the Cho/tCr and mI/tCr ratios were observed for the frontal grey matter, frontal white matter, temporal white matter and basal ganglia as compared with controls. There was no significant difference in the NAA/tCr ratios at all VOIs between the ESRD patients and the healthy controls. CONCLUSIONS Proton MRS is a useful and non-invasive imaging tool for the detection of early cerebral metabolic changes in neurologically presymptomatic ESRD patients.
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Effect of propofol on the levels of neurotransmitters in normal human brain: A magnetic resonance spectroscopy study. Neurosci Lett 2009; 467:247-51. [DOI: 10.1016/j.neulet.2009.10.052] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 09/15/2009] [Accepted: 10/16/2009] [Indexed: 11/20/2022]
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Gimenez M, Soria-Pastor S, Junque C, Caldu X, Narberhaus A, Botet F, Bargallo N, Falcon C, Mercader JM. Proton magnetic resonance spectroscopy reveals medial temporal metabolic abnormalities in adolescents with history of preterm birth. Pediatr Res 2008; 64:572-7. [PMID: 18596571 DOI: 10.1203/pdr.0b013e3181841eab] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prematurity is associated with volumetric reductions in specific brain areas such as the hippocampus and with metabolic changes that can be detected by spectroscopy. Short echo time (35 ms) Proton magnetic resonance spectroscopy (1H MRS) was performed to assess possible medial temporal lobe metabolic abnormalities in 21 adolescents with preterm birth (mean age: 14.8, SD: 1.3) compared with an age-matched control sample (mean age: 14.8, SD: 1.6). 1H MRS spectra were analyzed with linear combination model fitting, obtaining the absolute metabolite concentrations for Creatine (Cr), and myo-inositol (Ins). In addition, the following metabolite sums were measured: total Cho (glycerophospho-choline + phosphocholine), total N-acetyl-aspartate + N-acetyl-aspartylglutamate (NA), and total Glx (glutamate + glutamine). A stereological analysis was performed to calculate hippocampal volume. Absolute Cr, and total NA values were decreased in the preterm group (p = 0.016; p = 0.002, respectively). The preterm also showed a hippocampal reduction (p < 0.0001). Significant relationships were found between gestational age and different metabolites and the hippocampal volume. Moreover, hippocampal volume correlated with brain metabolites in the whole sample. Results demonstrate that prematurity affects medial temporal lobe metabolites, and that the alteration is related to structural changes, suggesting that the cerebral changes persist until adolescence.
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Affiliation(s)
- Monica Gimenez
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona 08036, Spain
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Wang Y, Zhang JX, Du XX, Zhao L, Tian Q, Zhu LQ, Wang SH, Wang JZ. Temporal correlation of the memory deficit with Alzheimer-like lesions induced by activation of glycogen synthase kinase-3. J Neurochem 2008; 106:2364-74. [PMID: 18643871 DOI: 10.1111/j.1471-4159.2008.05578.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We have reported that activation of glycogen synthase kinase-3 (GSK-3) by ventricle injection of wortmannin (WT) and GF-109203X (GFX) induces Alzheimer-like memory deficit in rats [Liu et al., J. Neurochem. 87 (2003), 1333]. To further explore the factors responsible for the memory loss, we studied here the temporal alterations of GSK-3, tau phosphorylation, beta-amyloid (Abeta), and acetylcholine (ACh) after injection of WT/GFX, and analyzed their correlation with the memory loss. We observed that the severe memory deficit occurred at 24 and 48 h, and simultaneously, GSK-3 activation, tau hyperphosphorylation at Thr231, Ser396, and Ser404 and decline of ACh in hippocampus were detected, and these changes were mostly recovered at 72 and 96 h after the injection of WT/GFX. Remarkable increase of Abeta and intracellular accumulation of argentophilic substances were detected at 72 h. Pearson analysis showed that the memory deficit was correlated with GSK-3 activation, tau hyperphosphorylation, and decline of ACh but not with Abeta overproduction. Our data provide direct evidence demonstrating that activation of GSK-3 by WT/GFX may cause memory deficit through tau hyperphosphorylation and suppression of ACh in hippocampus.
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Affiliation(s)
- Yue Wang
- Department of Pathophysiology, Key Laboratory of Neurological Disease of National Education Committee, Tongji Medical College, Huazhong University of Science and Technical, Wuhan, China
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Hammen T, Hildebrandt M, Stadlbauer A, Doelken M, Engelhorn T, Kerling F, Kasper B, Romstoeck J, Ganslandt O, Nimsky C, Blumcke I, Doerfler A, Stefan H. Non-invasive detection of hippocampal sclerosis: correlation between metabolite alterations detected by (1)H-MRS and neuropathology. NMR IN BIOMEDICINE 2008; 21:545-552. [PMID: 18035849 DOI: 10.1002/nbm.1222] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We assessed (1)H-MRS as a screening tool for detection of hippocampal sclerosis in patients with temporal lobe epilepsy (TLE). (1)H-MRS was carried out in the hippocampus of 23 patients with unilateral TLE. Metabolite alterations detected by (1)H-MRS correlated with degree of segmental neuronal cell loss and amount of astrogliosis. Positive correlation was found between total N-Acetylaspartate (tNAA) reduction and neuronal density in hippocampal CA1 (P < 0.001), CA3 (P = 0.015), and CA4 subfields (P = 0.031) and the dentate gyrus (P = 0.006). Neuronal cell loss in CA1 turned out to be the most predictive and only significant variable for tNAA reduction (P = 0.027). The association between myo-inositol (m-Ins) and astroglial glial fibrillary acidic protein (GFAP) expression revealed significantly increased m-Ins concentrations associated with diffuse astrogliosis (m-Ins = 6.4 +/- 1.1 institutional units) compared with gliosis restricted to isolated sectors of the hippocampus (i.e. hilus) (m-Ins = 5.2 +/- 1.2 institutional units) (P = 0.039). A negative correlation was found between m-Ins and neuronal loss in the CA4 subfield of the hippocampus (P = 0.028). Our results support (1)H-MRS as a suitable non-invasive method for preoperative identification of hippocampal sclerosis in patients with TLE. The extent of tNAA reduction correlates with hippocampal neuronal cell density. Furthermore, m-Ins is associated with the extent of hippocampal astrogliosis.
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Affiliation(s)
- Thilo Hammen
- Center Epilepsy Erlangen (ZEE), Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.
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Bartha R, Megyesi JF, Watling CJ. Low-grade glioma: correlation of short echo time 1H-MR spectroscopy with 23Na MR imaging. AJNR Am J Neuroradiol 2008; 29:464-70. [PMID: 18238848 DOI: 10.3174/ajnr.a0854] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is considerable variability in the clinical behavior and treatment response of low-grade (WHO grade II) gliomas. The purpose of this work was to characterize the metabolic profile of low-grade gliomas by using short echo time (1)H-MR spectroscopy and to correlate metabolite levels with MR imaging-measured sodium ((23)Na) signal intensity. Based on previous studies, we hypothesized decreased N-acetylaspartate (NAA) and increased myo-inositol (mIns), choline (Cho), glutamate (Glu), and (23)Na signal intensity in glioma tissue. MATERIALS AND METHODS Institutional ethics committee approval and informed consent were obtained for all of the subjects. Proton ((1)H-MR) spectroscopy (TR/TE = 2200/46 ms) and sodium ((23)Na) MR imaging were performed at 4T in 13 subjects (6 women and 7 men; mean age, 44 years) with suspected low-grade glioma. Absolute metabolite levels were quantified, and relative (23)Na levels were measured in low-grade glioma and compared with the contralateral side in the same patients. Two-sided Student t tests were used to test for statistical significance. RESULTS Significant decreases were observed for NAA (P < .001) and Glu (P = .004), and increases were observed for mIns (P = .003), Cho (P = .025), and sodium signal intensity (P < .001) in low-grade glioma tissue. Significant correlations (r(2) > 0.25) were observed between NAA and Glu (P < .05) and between NAA and mIns (P < .01). Significant correlations were also observed between (23)Na signal intensity and NAA (P < .01) and between (23)Na signal intensity and Glu (P < .01). Ratios of NAA/mIns, NAA/(23)Na, and NAA/Cho were altered in glioma tissue (P < .001); however based on the t statistic, NAA/(23)Na (t = 9.6) was the most significant, followed by NAA/mIns (t = 6.1), and NAA/Cho (t = 5.0). CONCLUSION Although Glu concentration is reduced and mIns concentration is elevated in low-grade glioma tissue, the NAA/(23)Na ratio was the most sensitive indicator of pathologic tissue.
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Affiliation(s)
- R Bartha
- Laboratory for Functional Magnetic Resonance Research, Robarts Research Institute, London, Ontario, Canada.
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Lucetti C, Del Dotto P, Gambaccini G, Ceravolo R, Logi C, Berti C, Rossi G, Bianchi MC, Tosetti M, Murri L, Bonuccelli U. Influences of dopaminergic treatment on motor cortex in Parkinson disease: a MRI/MRS study. Mov Disord 2008; 22:2170-5. [PMID: 17722082 DOI: 10.1002/mds.21576] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to investigate neurochemical and metabolic changes in the motor cortex in a group of de novo Parkinson's disease (PD) patients before and after 6 mo treatment with the dopamine agonist pergolide. Proton magnetic resonance spectroscopy (1H-MRS) has been used to study striatal and cortical metabolism in PD and other parkinsonisms. So far, no studies evaluating possible brain metabolic changes in PD patients before and after dopaminergic therapy have been reported. De novo PD patients (11) and controls (11) underwent clinical evaluation (UPDRS-III motor evaluation) and a first single-voxel 1H-MRS of the motor cortex. 1H-MRS studies were performed using the PROBE-SV System implemented on a 1.5 Tesla Scanner (GE Medical System, Milwaukee, WI). Pergolide was administered up to a dose of 1 mg t.i.d. After 6 mo follow-up, all patients were clinically evaluated and a second single-voxel 1H-MRS was performed. Lower values of Cho/Cr and NAA/Cr ratios were observed in the motor cortex of PD patients compared with controls (P < 0.02 and P < 0.01, respectively). After 6 mo therapy with pergolide (1 mg t.i.d), PD patients showed an improvement in motor performances (P < 0.05) and an increase in Cho/Cr ratios in the motor cortex at the second 1H-MRS evaluation (P < 0.05) was reported. In conclusion, cortical NAA/Cr and Cho/Cr ratios may be impaired in de novo PD. Dopaminergic therapy capable of improving motor function may restore the Cho/Cr ratio in the motor cortex.
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Abstract
Neurodegenerative and infectious disorders including Alzheimer's and Parkinson's diseases, amyotrophic lateral sclerosis, and stroke are rapidly increasing as population's age. Alzheimer's disease alone currently affects 4.5 million Americans, and more than $100 billion is spent per year on medical and institutional care for affected people. Such numbers will double in the ensuing decades. Currently disease diagnosis for all disorders is made, in large measure, on clinical grounds as laboratory and neuroimaging tests confirm what is seen by more routine examination. Achieving early diagnosis would enable improved disease outcomes. Drugs, vaccines or regenerative proteins present "real" possibilities for positively affecting disease outcomes, but are limited in that their entry into the brain is commonly restricted across the blood-brain barrier. This review highlights how these obstacles can be overcome by polymer science and nanotechnology. Such approaches may improve diagnostic and therapeutic outcomes. New developments in polymer science coupled with cell-based delivery strategies support the notion that diseases that now have limited therapeutic options can show improved outcomes by advances in nanomedicine.
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Hammen T, Schwarz M, Doelken M, Kerling F, Engelhorn T, Stadlbauer A, Ganslandt O, Nimsky C, Doerfler A, Stefan H. 1H-MR spectroscopy indicates severity markers in temporal lobe epilepsy: correlations between metabolic alterations, seizures, and epileptic discharges in EEG. Epilepsia 2007; 48:263-9. [PMID: 17295619 DOI: 10.1111/j.1528-1167.2006.00856.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE In this study, hippocampal metabolite alterations in (1)H-MR spectroscopy ((1)H-MRS) were correlated to the findings of intensive video-EEG monitoring and duration of seizure symptoms in patients with temporal lobe epilepsy (TLE). METHODS The 14 patients with mesial TLE and no pathological findings in imaging were investigated by (1)H-MRS. Seizures were analyzed by: number of clinical seizures in 24 h, exact duration of clinical symptoms in 24 h, frequency of interictal epileptiform discharges (IEDs) and ictal activity, duration of ictal activity, and IEDs occurring within 24 h in intensive EEG monitoring. Pearson Correlation Coefficient (PCC) was calculated between spectral metabolite alterations and the parameters mentioned above. RESULTS In the analysis, a negative correlation was found between total (t) NAA values and degree of IEDs in EEG (p = 0.04); a positive correlation was found between Cr levels and duration of seizure symptoms registered by video monitoring (p = 0.01). CONCLUSIONS Our study shows that, in some patients, (1)H-MRS is able to refer the severity of TLE. The degree of tNAA reduction in (1)H-MRS, probably indicating neuronal dysfunction, is associated with interictal spiking in intensive EEG monitoring. Duration of seizure symptoms associated with increased Cr peaks probably reflects increased gliosis.
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Affiliation(s)
- Thilo Hammen
- Center Epilepsy Erlangen, Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
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Boucard CC, Hoogduin JM, van der Grond J, Cornelissen FW. Occipital proton magnetic resonance spectroscopy (1H-MRS) reveals normal metabolite concentrations in retinal visual field defects. PLoS One 2007; 2:e222. [PMID: 17311099 PMCID: PMC1794168 DOI: 10.1371/journal.pone.0000222] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Accepted: 01/23/2007] [Indexed: 11/17/2022] Open
Abstract
Background Progressive visual field defects, such as age-related macular degeneration and glaucoma, prevent normal stimulation of visual cortex. We investigated whether in the case of visual field defects, concentrations of metabolites such as N-acetylaspartate (NAA), a marker for degenerative processes, are reduced in the occipital brain region. Methodology/Principal Findings Participants known with glaucoma, age-related macular degeneration (the two leading causes of visual impairment in the developed world), and controls were examined by proton MR spectroscopic (1H-MRS) imaging. Absolute NAA, Creatine and Choline concentrations were derived from a single-voxel in the occipital region of each brain hemisphere. No significant differences in metabolites concentrations were found between the three groups. Conclusions/Significance We conclude that progressive retinal visual field defects do not affect metabolite concentration in visual brain areas suggesting that there is no ongoing occipital degeneration. We discuss the possibility that metabolite change is too slow to be detectable.
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Affiliation(s)
- Christine C Boucard
- CBCN Neuro-imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Hammen T, Kerling F, Schwarz M, Stadlbauer A, Ganslandt O, Keck B, Tomandl B, Dörfler A, Stefan H. Identifying the affected hemisphere by (1)H-MR spectroscopy in patients with temporal lobe epilepsy and no pathological findings in high resolution MRI. Eur J Neurol 2006; 13:482-90. [PMID: 16722973 DOI: 10.1111/j.1468-1331.2006.01293.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Up to 30% of patients with temporal lobe epilepsy (TLE) remain without remarkable changes in MRI. In this study we investigated the role of (1)H-MR spectroscopy ((1)H-MRS) in lateralizing the affected hemisphere in the mentioned patient group. Twenty-two consecutive patients diagnosed with TLE were investigated by high resolution MRI and (1)H-MRS. We examined the incidence and diagnostic accuracy of temporal metabolite alterations determined by Linear Combination of Model Spectra (L C Model) via water reference. Metabolite values of each hemisphere of TLE patients were compared with healthy controls. Results of metabolite alterations were related to intensive video EEG focus localization. Reduction of N-acetylaspartate + N-acetylaspartyl-glutamate (tNAA) in the affected hemisphere revealed identification in six of nine patients (66%) with unilateral TLE. Group comparison revealed a significant reduction of tNAA (6.1+/-0.8*) in the involved temporal lobe compared with controls (6.67+/-0.4*, P=0.026). Choline levels were significantly increased in the affected hemisphere (1.42+/-0.17*) compared with healthy controls (1.22+/-0.17*, P=0.035). The results of our study show that (1)H-MRS is able to identify the affected hemisphere of MRI negative TLE patients and can be used as an additive tool in multimodal focus localization.
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Affiliation(s)
- T Hammen
- Clinics of Neurology, Epilepsy Center (ZEE), University of Erlangen-Nuremberg, Erlangen, Germany.
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Wang S, Poptani H, Woo JH, Desiderio LM, Elman LB, McCluskey LF, Krejza J, Melhem ER. Amyotrophic Lateral Sclerosis: Diffusion-Tensor and Chemical Shift MR Imaging at 3.0 T. Radiology 2006; 239:831-8. [PMID: 16641339 DOI: 10.1148/radiol.2393050573] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To prospectively determine whether diffusion-tensor magnetic resonance (MR) imaging in conjunction with two-dimensional chemical shift imaging can assist in identifying upper motor neuron involvement and whether disease severity and duration can be predicted based on imaging parameters in patients with amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Fifteen patients with ALS (12 men, three women; mean age, 57.3 years) with clinical evidence of upper motor neuron involvement and 10 healthy control subjects (five men and five women; mean age, 49.4 years) were studied. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured from the corticospinal tracts at the level of the internal capsule. Average N-acetylaspartate (NAA)/creatine-phosphocreatine (Cr) and NAA/choline-containing compounds (Cho) ratios were calculated from the precentral gyrus. Student t test, multiple linear regression analysis, and Spearman correlation coefficients were employed to quantify relationships between imaging and clinical parameters. RESULTS Patients with ALS exhibited significantly reduced FA values and NAA/Cr and NAA/Cho ratios compared with values in control subjects (P<.05) for both affected and nonaffected sides of the brain. ADC was elevated significantly in the affected side (P<.05) and was an independent predictor of disease duration after adjusting for age; however, FA values and NAA/Cr ratios for the affected side were even stronger predictors of disease duration. Moderate but statistically significant correlation was found between the FA values for the affected side and the ALS Functional Rating Scale Revised (ALSFRS-R) score (r=0.51, P<.05). The NAA/Cr ratio also correlated with both the ALSFRS-R and upper motor neuron scores (r=0.50 and 0.54, respectively; P<.05). CONCLUSION Diffusion-tensor and two-dimensional chemical shift MR imaging spectroscopy can be used to identify upper motor neuron involvement and predict disease duration in patients with ALS.
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Affiliation(s)
- Sumei Wang
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Dulles 2, Philadelphia, PA 19104, USA
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Engelhardt E, Moreira DM, Laks J, Cavalcanti JLS. Alzheimer's disease and proton magnetic resonance spectroscopy of limbic regions: a suggestion of a clinical-spectroscopic staging. ARQUIVOS DE NEURO-PSIQUIATRIA 2006; 63:195-200. [PMID: 16100961 DOI: 10.1590/s0004-282x2005000200001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare magnetic resonance proton spectroscopic with clinical data and to propose a spectroscopic staging of Alzheimer's disease (AD). METHOD Subjects (n = 46), normals (12) and with AD (34), paired to age (CDR0-CDR3); AD diagnosis according to DSM-IV/NINCDS-ADRDA criteria; 1H-MRS with Signa Horizon LX-GE, 1.5T; single voxel at hippocampal region/HCR and posterior cingulate area/PCA. RESULTS Statistically significant decrease (p < 0.01) only of Naa/Cr--at HCR among the CDR0, CDR1+CDR2, and CDR3, and at PCA between CDR0 and CDR1+CDR2 in relation to CDR3. CONCLUSION The HCR is the first to show Naa reduction (CDR1). The PCA suffers later (CDR3). These values decline progressively according to the severity stages. Considering the disparities between the HCR and PCA it is possible to suggest a spectroscopic (metabolite) staging (MS) of AD, as follows: MS0 (-CDR0) = both normal HCR and PCA, MS1-2 (approximately CDR1-2) = abnormal HCR and normal PCA, and MS3 (approximately CDR3) = both abnormal HCR and PCA. These results make possible the early diagnosis, to follow the degenerative process throughout the course, and to suggest a spectroscopic staging related to the clinical stages of AD.
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Affiliation(s)
- Eliasz Engelhardt
- Division of Cognitive and Behavioral Neurology, Instituto de Neurologia Deolindo Couto, Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil.
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Abstract
The number of elderly people is increasing rapidly and, therefore, an increase in neurodegenerative and cerebrovascular disorders causing dementia is expected. Alzheimer disease (AD) is the most common cause of dementia. Vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are the most frequent causes after AD, but a large proportion of patients have a combination of degenerative and vascular brain pathology. Characteristic magnetic resonance (MR) imaging findings can contribute to the identification of different diseases causing dementia. The MR imaging protocol should include axial T2-weighted images (T2-WI), axial fluid-attenuated inversion recovery (FLAIR) or proton density-weighted images, and axial gradient-echo T2*-weighted images, for the detection of cerebrovascular pathology. Structural neuroimaging in dementia is focused on detection of brain atrophy, especially in the medial temporal lobe, for which coronal high resolution T1-weighted images perpendicular to the long axis of the temporal lobe are extremely important. Single photon emission computed tomography and positron emission tomography may have added value in the diagnosis of dementia and may become more important in the future, due to the development of radioligands for in vivo detection of AD pathology. New functional MR techniques and serial volumetric imaging studies to identify subtle brain abnormalities may also provide surrogate markers for pathologic processes that occur in diseases causing dementia and, in conjunction with clinical evaluation, may enable a more rigorous and early diagnosis, approaching the accuracy of neuropathology.
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Affiliation(s)
- António J Bastos Leite
- Department of Radiology, Vrije Universiteit (VU) Medical Center, Amsterdam, the Netherlands.
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Dedeoglu A, Choi JK, Cormier K, Kowall NW, Jenkins BG. Magnetic resonance spectroscopic analysis of Alzheimer's disease mouse brain that express mutant human APP shows altered neurochemical profile. Brain Res 2004; 1012:60-5. [PMID: 15158161 DOI: 10.1016/j.brainres.2004.02.079] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2004] [Indexed: 11/24/2022]
Abstract
Transgenic mice that express mutant human amyloid precursor protein (APPTg2576) develop beta-amyloid (Abeta) plaques throughout the cortex starting at 10-12 months of age. We examined the neurochemical profile of APPTg2576 mice using in vitro and in vivo magnetic resonance spectroscopy (MRS); gross abnormalities using magnetic resonance imaging (MRI) and plaque distribution; size and number using immunohistochemistry. Transgenic mice were anesthetized with halothane and scanned at 4.7 T using T2-weighted imaging and in vivo MRS of frontal cortex. In vitro MRS was run from brain extracts of frontal cortex in both APP and wild-type mice. Mice were also perfused and brains were collected and cut for immunohistochemistry. We found that N-acetylaspartate (NAA), glutamate and glutathione were decreased by 17%, 22% and 36%, respectively, in the cerebral cortex of APP transgenic mice at 19 months of age when Abeta deposits are widespread. Taurine was increased 21% compared to wild-type. Decreased levels of NAA and increased levels of taurine are consistent with decreased neuronal viability and increased glial volume, and are similar to findings of decreased NAA and increased myo-inositol in human Alzheimer's disease (AD) brains. Correlation between the severity of Abeta deposition and altered neurochemical profile remains to be studied. Nevertheless, the altered neurochemical profile may be a valuable marker to test therapeutics in this mouse model.
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Affiliation(s)
- Alpaslan Dedeoglu
- Geriatric Research Education and Clinical Center, Bedford Veterans Administration Medical Center, MA 01730, USA.
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Lu ZH, Chakraborty G, Ledeen RW, Yahya D, Wu G. N-Acetylaspartate synthase is bimodally expressed in microsomes and mitochondria of brain. ACTA ACUST UNITED AC 2004; 122:71-8. [PMID: 14992817 DOI: 10.1016/j.molbrainres.2003.12.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2003] [Indexed: 11/19/2022]
Abstract
N-Acetylaspartate (NAA) is an abundant amino acid derivative of the central nervous system that is localized primarily in neurons and has found widespread use in clinical NMR spectroscopy (MRS) as a non-invasive indicator of neuronal survival and/or viability. Its function, although still obscure, is thought to reflect its unusual metabolic compartmentalization wherein NAA synthase occurs in the neuron and aspartoacylase, the hydrolytic enzyme that removes the acetyl moiety, occurs in myelin and glia. The NAA synthase enzyme, acetyl-CoA/l-aspartate N-acetyltransferase (ANAT), was previously shown to function in mitochondria (MIT), although other subcellular fractions were apparently not examined. In this study we confirmed its presence in MIT but also found significant activity in rat brain microsomes (MIC). The reaction mixture, consisting of [(14)C]aspartate plus acetyl-CoA in Na-phosphate buffer (pH 7), gave rise to [(14)C]NAA that was separated and quantified by TLC. Reaction rates were 29.0+/-0.46 and 6.27+/-0.27 nmol/h/mg for MIC and MIT, respectively. K(m) values and pH optima were similar, and both fractions showed modest enhancement of ANAT activity with the detergents Triton CF-54 and CHAPS. Our tentative conclusion is that ANAT is bimodally targeted to MIT and a component of MIC-likely endoplasmic reticulum. ANAT activity increased in both MIC and MIT between 29 and 60 days of age but differed thereafter in that only MIT ANAT showed a decrease after 1 year.
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Affiliation(s)
- Zi-Hua Lu
- Department of Neurology and Neurosciences, MSB-H506, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA
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Giménez M, Junqué C, Narberhaus A, Caldú X, Segarra D, Vendrell P, Bargalló N, Mercader JM. Medial temporal MR spectroscopy is related to memory performance in normal adolescent subjects. Neuroreport 2004; 15:703-7. [PMID: 15094480 DOI: 10.1097/00001756-200403220-00026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In addition to the study of pathological conditions, magnetic resonance spectroscopy can provide useful information about brain-behavior relationships in normal subjects. Recently, there have been reports of correlations between N-acetylaspartate (NAA) values and cognitive functions in normal adults. We tested the possible specific relationship between the NAA/choline (Cho) ratio in the medial temporal lobe and memory performance in normal adolescents. The medial temporal NAA/Cho ratio was unrelated to age, gender and general intelligence but presented a clear correlation with several memory measures. In the regression analysis two memory variables (RAVLT learning and a face-name recognition task) explained 55.6% of NAA/Cho variance. We conclude that NAA values in the medial temporal lobe are related to memory abilities but not to global intelligence in normal adolescent subjects.
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Affiliation(s)
- Mónica Giménez
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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