Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function

Kwan, Lawrence T.; Reed, Bruce R; Eberling, Jamie L.; Schuff, Norbert; Tanabe, Jody; Norman, David; Weiner, Michael W.

doi:10.1001/archneur.56.7.809

Cited by 89 publications

(47 citation statements)

References 57 publications

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“…This contradiction of GABA-A receptor expression in early and adult brain damage is not surprising since the motor cortex of congenital hemiplegia patients has shown increased metabolism (28) whereas decreased glucose metabolism has been shown in adults damaged by stroke (29). It is well known that cortical disinhibition promotes neural plasticity, especially practice-dependent plasticity (30).…”

Section: Discussionmentioning

confidence: 99%

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Kim

Park

et al. 2013

J Nucl Med

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Section: Discussionmentioning

confidence: 99%

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Kim

Park

et al. 2013

J Nucl Med

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“…In brief, fractal dimension within the CNS increases with childhood and adolescence, and then decreases in association with age, [44] which parallels the rise and fall in entropy production over the same time frames [77] as well as the decrease in glucose metabolism with age [72,81,82]. Moreover, fractal studies have demonstrated a decrease in fractal dimension of the CNS with illness (i.e., Alzheimer's [42], epilepsy [23,24], MS [45], stroke [49]) which correlates with metabolic studies demonstrating a decline in glucose metabolism with illness [83,85,88,[90][91][92][93][94][95][96][97][101][102][103]. Conversely, there are diseases which demonstrate an increase in fractal dimension including cancer [50][51][52][53][54][55] and grey matter structural changes in MS [46].…”

Section: Discussionmentioning

confidence: 67%

“…Early studies demonstrated a significant association between reduced ipsilateral cortical metabolism and the occurrence of aphasia or neglect following subcortical stroke [101,102]. Furthermore, studies have demonstrated that subcortical stroke produces global cerebral hypometabolism which has a negative correlation with cognitive function and clinical status of the patient [103]. Overall the loss of complexity and fractal dimension in the brain following stroke correlates with these metabolic studies, demonstrating a concomitant reduction in fractal dimension and cerebral metabolism as a consequence of stroke.…”

Section: Strokementioning

confidence: 97%

Fractal Structure and Entropy Production within the Central Nervous System

Seely

Newman

Herry

2014

Entropy

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Abstract:Our goal is to explore the relationship between two traditionally unrelated concepts, fractal structure and entropy production, evaluating both within the central nervous system (CNS). Fractals are temporal or spatial structures with self-similarity across scales of measurement; whereas entropy production represents the necessary exportation of entropy to our environment that comes with metabolism and life. Fractals may be measured by their fractal dimension; and human entropy production may be estimated by oxygen and glucose metabolism. In this paper, we observe fractal structures ubiquitously present in the CNS, and explore a hypothetical and unexplored link between fractal structure and entropy production, as measured by oxygen and glucose metabolism. Rapid increase in both fractal structures and metabolism occur with childhood and adolescent growth, followed by slow decrease during aging. Concomitant increases and decreases in fractal structure and metabolism occur with cancer vs. Alzheimer's and multiple sclerosis, respectively. In addition to fractals being related to entropy production, we hypothesize that the emergence of fractal structures spontaneously occurs because a fractal is more efficient at dissipating energy gradients, thus maximizing entropy production. Experimental evaluation and further understanding of limitations and necessary conditions are indicated to address broad scientific and clinical implications of this work.

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“…This is consistent with PET studies showing in SIVD hypometabolism and hypoperfusion in cortical regions, (6) especially in the frontal lobe. (7) In support of this view, MRS studies on animals have shown trans-synaptic decrease of NAA levels following acute deafferentation without neuronal loss. (8) It is therefore conceivable that the cortical [NAA] losses in SIVD could indicate deafferented neurons in a state of functional inactivity with a possibility for recovery rather than frank neuron loss.…”

Section: Subcortial Ischemic Vascular Dementiamentioning

confidence: 90%

N-Acetylaspartate as a Marker of Neuronal Injury in Neurodegenerative Disease

Schuff¹,

Meyerhoff²,

Mueller³

et al.

Advances in Experimental Medicine and Biology

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Considerable evidence suggests that normal aging is associated with gradual impairment of memory functioning [1]. The medial temporal lobe, especially the hippocampus, plays a central role in declarative memory processing [2]. However, magnetic resonance imaging (MRI) studies have produced controversial results concerning the age-related hippocampal volume loss, which could be due in part to the non-specificity of volume shrinkage as an indicator for neuron loss. In contrast to volume, NAA is generally considered a marker for viable neurons, because NAA reaches detectable concentrations only in neuronal tissue but not in other brain tissues, including glial cells. Using proton magnetic resonance spectroscopic imaging ( 1 H MRSI) and MRI together, we studied hippocampal metabolites and volumes in 24 healthy adults from 36 to 85 years of age. Our goals were to test whether NAA levels vary in the hippocampus as a function of normal aging and 2) to determine the relationship between hippocampal NAA and volume changes. We found NAA/Cho ratios decreased by 24% (r = −0.53, p = 0.01) and NAA/Cr ratios decreased by 26% (r = −0.61, p < 0.005) over the age range studied, while Cho/Cr remained stable, implying diminished NAA levels. In the same population, hippocampal volume shrank by 20% (r = −0.64, p < 0.05). The relationships of these measures with aging are depicted in Figure 1. Since NAA is considered a marker of neurons, these results provide stronger support for neuron loss in the aging hippocampus than volume measurements by MRI alone.Since contributions to the NAA signal may arise from both gray and white matter tissue, it is critical to differentiate between metabolite changes of gray and white matter, and other tissue types. One approach for differentiation is the use of linear regressions to predict the relationship between metabolite intensity changes and gray/white matter variations in MRSI voxels (4,(8)(9)(10)(11)(12). However, most previous MRSI studies that used linear regression averaged metabolite concentrations over different lobes of the brain, ignoring regional variations. In addition, tissues other than gray and white matter were ignored or not determined, such as white matter lesions, which occur frequently in the aged brain. We developed an approach for obtaining metabolite concentrations of gray, white matter, as well as of white matter lesions in different lobes of the brain using linear regression. We applied the new technique to measure NAA concentrations in the frontal and the parietal lobe in 40 normal elderly subjects (56 to 89 years, mean age 74 ± 8, 22 female, 18 male). NAA was about 15% lower in cortical gray matter and 23% lower in white matter lesions when compared to normal white matter. Cr was 11% higher in cortical gray than in white matter, and also about 15% higher in the parietal cortex compared to the frontal cortex. Cho was 28% lower in cortical gray matter than in white matter. Furthermore, NAA and Cr changes correlated with age. The results suggest that in addition to the hippo...

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Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function

Cited by 89 publications

References 57 publications

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Fractal Structure and Entropy Production within the Central Nervous System

N-Acetylaspartate as a Marker of Neuronal Injury in Neurodegenerative Disease

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Effects of Subcortical Cerebral Infarction on Cortical Glucose Metabolism and Cognitive Function

Cited by 89 publications

References 57 publications

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using 18F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using 18F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Fractal Structure and Entropy Production within the Central Nervous System

N-Acetylaspartate as a Marker of Neuronal Injury in Neurodegenerative Disease

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Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using ¹⁸F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging