Changes in the organization of the brain after recovery from aphasia were investigated by measuring increases in regional cerebral blood flow (rCBF) during repetition of pseudowords and during verb generation. Six right-handed patients who had recovered from Wernicke's aphasia caused by an infarction destroying the left posterior perisylvian language zone were compared with 6 healthy, right-handed volunteers. In the control subjects, strong rCBF increases were found in the left hemisphere in the posterior part of the superior and middle temporal gyrus (Wernicke's area), and during the generation task in lateral prefrontal cortex (LPFC) and in inferior frontal gyrus (Broca's area). There were some weak right hemisphere increases in superior temporal gyrus and inferior premotor cortex. In the patients, rCBF increases were preserved in the frontal areas. There was clear right hemisphere activation in superior temporal gyrus and inferior premotor and lateral prefrontal cortices, homotopic to the left hemisphere language zones. Increased left frontal and right perisylvian activity in patients with persisting destruction of Wernicke's area emphasizes redistribution of activity within the framework of a preexisting, parallel processing and bilateral network as the central mechanism in functional reorganization of the language system after stroke.
This report describes the precursor synthesis and the no-carrier-added (nca) radiosynthesis of the new A(1) adenosine receptor (A(1)AR) antagonist [(18)F]8-cyclopentyl-3-(3-fluoropropyl)-1-propylxanthine (CPFPX), 3, with fluorine-18 (half-life = 109.6 min). Nucleophilic radiofluorination of the precursor tosylate 8-cyclopentyl-3-(3-tosyloxypropyl)-7-pivaloyloxymethyl-1-propylxanthine, 2, with nca [(18)F]KF under aminopolyether-mediated conditions (Kryptofix 2.2.2/K(2)CO(3)) followed by deprotection was straightforward and, after formulation, gave the radioligand ready for injection with a radiochemical yield of 45 +/- 7%, a radiochemical purity of >98% and a specific radioactivity of >270 GBq/micromol (>7.2 Ci/micromol). Preparation time averaged 55 min. The synthesis proved reliable for high batch yields ( approximately 7.5 GBq) in routine production (n = 120 runs). The radiotracer was pharmacologically evaluated in vitro and in vivo and its pharmacokinetics in rodents determined in detail. After iv injection a high accumulation of radioactivity occurred in several regions of mouse brain including thalamus, striatum, cortex, and cerebellum. Antagonism by the specific A(1)AR antagonists 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) and N(6)-cyclopentyl-9-methyladenine (N-0840), but not with the A(2)AR antagonist 3,7-dimethyl-1-propargylxanthine (DMPX), indicated specific and reversible binding of the radioligand to A(1)AR in cortical and subcortical regions of interest. In mouse blood at least two polar metabolites formed rapidly (50% at 5 min after tracer application). However, chromatographic analyses of brain homogenate extracts taken 60 min pi showed that >98% of radioactivity was unchanged radioligand. Chromatographic isolation and reinjection of peripherally formed radioactive metabolites revealed no accumulation of radioactivity in mouse brain, probably due to the polarity of the metabolites. These preliminary results suggest that nca [(18)F]CPFPX is a useful radioligand for the noninvasive imaging of the brain A(1)AR.
Positron emission tomography (PET) is a useful procedure for assessing the density (Phelps, 2000) and pharmacological properties of receptors in vivo (Merlet et al., 1993;Beugel et al., 1999). However, receptor-PET studies favor radioligands that are either stable in the body or that give rise to metabolites that do not interfere with the imaging of specifically bound ligand.The ligand (Holschbach et al., 2002) is used to image the A 1 adenosine receptor (A 1 AR) in human brain (Bauer et al., 2003). Because this ligand does not undergo degradation in the central nervous system, specifically bound ligand accounts for a very large fraction of brain radioactivity. However, such is not the case in peripheral tissues. The metabolism of [18 F]CPFPX in primates (Boy et al., 1998) and humans gives rise to at least three polar metabolites in blood, and studies illustrated the confounding effects of these metabolites. For example, the intravenous administration of [18 F]CPFPX to experimental animals caused intense labeling of the heart that was unaffected by the administration of unlabeled ligand, evidence for high unspecific binding of a metabolite (Holschbach et al., 1998).The physiological importance of the A 1 AR, its wide tissue distribution, and the success of PET-imaging A 1 ARs in the central nervous system urge extension of this technique to other organs. The design of more stable radioligands to achieve that end requires the kind of information about the metabolism of [18 F]CPFPX provided by this study.Measurements of receptor density by PET depend on compartmental analysis by mathematical models that are very sensitive to the concentration of native radioligand in blood perfusing the organ (the "input function"). Such measurements on the plasma of human subjects (Meyer et al., 2004) identified several [18 F]CPFPX metabolites in addition to unchanged ligand. Because the radiotracers for PET studies are prepared under no-carrier-added conditions, the amount of compound administered is in the low to subnanomolar range, making direct spectrometric identification of metabolites impossible. As this report describes, incubating CPFPX with human liver microsomes generated compounds that by HPLC had the same mobilities as the metabolites in plasma, and LC-MS tentatively identified them by measuring m/z of the [M ϩ H] ϩ ions. The literature contains little information about the metabolism of synthetic xanthines. The use of CPFPX in humans for diagnostic and research PET imaging necessitates the knowledge of its metabolism in vivo. To our knowledge, the present study of the biotransformation of CPFPX in humans is the first of its kind.Article, publication date, and citation information can be found at
Adenosine is an important neuromodulator. Basic cerebral effects of adenosine are exerted by the A1 adenosine receptor (A1AR), which is accessible in vivo by the novel ligand [F]8-cyclopentyl-3-(3-fluoropropyl)-1-propylxanthine ([F]CPFPX) and positron emission tomography (PET). The present study investigates the applicability of kinetic models to describe the cerebral kinetics of [F]CPFPX in order to quantify A1AR density in vivo. Six healthy volunteers underwent dynamic PET scanning and arterial blood sampling after bolus injection of [F]CPFPX. For quantitative analysis, a standard two-tissue compartment model (2TCM) was compared with a one-tissue compartment model (1TCM) and Logan's graphical analysis (GA). The 2TCM described the cerebral kinetics of [F]CPFPX significantly better than the 1TCM (in all regions and subjects examined). The estimated values of the regional total distribution volumes (DVt) correlated strongly between the 2TCM and GA (linear regression r = 0.99, slope: 1.007). The DVt correlation between the 2TCM and the 1TCM was comparably high, but there was a significant bias towards lower DVt estimates given by the 1TCM (r: 0.99, slope: 0.929). It is concluded that a 2TCM satisfactorily accounts for the cerebral kinetics of [F]CPFPX. GA represents an attractive alternative method of analysis.
As basic CID reactions of caffeine have been elucidated in this work, the developed fragmentation scheme may serve as a valuable tool for the interpretation of ESI-CID fragmentation spectra of more complex xanthine derivatives and their respective metabolites.
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