Metabolic changes in the ischemic penumbra after carotid endarterectomy in stroke patients by localized in vivo proton magnetic resonance spectroscopy (H-MRS)

Kim, Geun Eun; Lee, Jun Young; Cho, Yong Pil; Kim, Sang‐Tae

doi:10.1016/s0967-2109(01)00016-3

Cited by 21 publications

(8 citation statements)

References 26 publications

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“…Our results indicate that Lac is a sensitive marker of anaerobic metabolism following cerebral ischemia, but the neuronal damage is secondary to cerebral ischemia and the reduction of the level of NAA occurred after the level of Lac increased. These results are in accordance with those in previous reports (17,18), in which acute cerebral infarction patients were studied, and it was observed that NAA levels were decreased.…”

Section: Discussionsupporting

confidence: 93%

Metabolic changes in acute cerebral infarction: Findings from proton magnetic resonance spectroscopic imaging

Lin

Shou

et al. 2013

Experimental and Therapeutic Medicine

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The purpose of this study was to investigate the clinical role of proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis of acute cerebral infarction. Using databases available at the Fifth Affiliated Hospital of Zhengzhou University (Zhengzhou, China), the medical records of 47 patients with acute cerebral infarction treated between April 2010 and March 2012 were retrospectively reviewed. The patients underwent routine magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI) and multiple-voxel 1H-MRS examination within 12 h after the onset of stroke. The patients then received normal medical treatment for 2 weeks and underwent follow-up 1H-MRS examination at 1–2 months after stroke. The concentrations of the main metabolites [N-acetylaspartic acid (NAA), creatine (Cr), choline (Cho) and lactate (Lac)] in the infarct center, the infarction border region and the contralateral brain areas (control) were analyzed. The 47 patients experienced changes in NAA, Cho and Lac levels at different stages after stroke. In the infarction center, the NAA/Cr and NAA/Cho ratios decreased, while the Lac/Cr ratio increased within 12 h compared with those in the contralateral side. Within 6–12 h after stroke, the Lac/Cr ratio increased and the NAA/Cho ratio decreased compared with those <6 h after stroke. During the 1–2 months post-stroke, significant reductions in the NAA/Cr, NAA/Cho, Cho/Cr and Lac/Cr ratios were observed in the infarction center. In the infarction border region, the Lac/Cr ratio increased significantly at 12 h and decreased during the 1–2 months after stroke. The NAA/Cr, NAA/Cho and Cho/Cr ratios were significantly increased in the infarction border regions of patients who received thrombolytic therapy for 1–2 months compared with those in patients who did not undergo thrombolysis. Our results highlight the usefulness of 1H-MRS-based metabolomics as a feasible and efficient prognostic tool for assessing the treatment effect of acute cerebral infarction.

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Section: Discussionsupporting

confidence: 93%

Metabolic changes in acute cerebral infarction: Findings from proton magnetic resonance spectroscopic imaging

Lin

Shou

et al. 2013

Experimental and Therapeutic Medicine

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“…1 In events such as ischemia, creatine cannot be used as an internal reference because its concentration varies with the anaerobic tissue conditions and, like in the current study, other authors have consistently found a general decrease in the concentration of creatine in the ischemic lesion. 7,8 Although metabolite ratios are still used because of the simplicity of their calculation, methods for quantifying individual metabolites are now well established.…”

Section: Discussionsupporting

confidence: 57%

“…1,2 This is based on the assumption that the concentrations of choline or creatine do not change significantly during ischemia. 3 The aim of the present article was to establish whether choline and creatine could be used as reliable denominators for other brain metabolites in ischemic stroke by investigating how their levels varied within the ischemic lesion over time.…”

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confidence: 99%

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Maniega

Cvoro

Armitage

et al. 2008

Stroke

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Background and Purpose-Choline and creatine are commonly used as denominators for other metabolites in ischemic stroke spectroscopy, assuming that they do not change. We investigated their concentration variation over time after stroke. Methods-Choline and creatine concentrations were measured by proton MR spectroscopic imaging in 51 patients at 5 times up to 3 months after stroke. Results-Choline and creatine levels changed significantly in the ischemic region. Choline was significantly reduced during the first 2 weeks after stroke onset (Pϭ0.034). Creatine was significantly reduced during the whole period of the study (Pϭ0.011). Conclusion-Choline and creatine concentrations are not reliable denominators for metabolite ratios in acute stroke because their levels vary significantly in ischemic brain regions.

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“…NAA is produced in the mitochondria of nerve cells; it is usually found in living cells and axons, and is recognized to be a marker of neuronal activity. Cr is stable in the brain and is often used as an internal reference to calculate metabolic product ratios in order to eliminate differences among individuals [35]. In this study, we used the NAA/Cr ratio as a biomarker of hippocampal metabolites.…”

Section: Agingmentioning

confidence: 99%

Secondary injury to distal regions after intracerebral hemorrhage influence neurological functional outcome

Song

Liu

Zheng

et al. 2020

Aging

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Although many studies have focused on functional impairment after intracerebral hemorrhage, little is known about the relationship between secondary injuries to distal regions and neurological function. Our study aimed to evaluate the secondary injuries after intracerebral hemorrhage and explore their relationship to neurological functional outcome. Twenty-one patients with hemorrhages in supratentorial, deep locations and 10 healthy subjects were recruited. Longitudinal examinations of diffusion tensor imaging, hydrogen proton magnetic resonance spectroscopy imaging and neuropsychological assessment were performed after weeks 1 and 12 to elucidate the relationship between magnetic resonance imaging parameters and neurologic outcomes. By week 12, motor function had significantly improved, but cognitive function had deteriorated compared to week 1. Fractional anisotropy values for the ipsilateral cerebral peduncle correlated with motor function at week 1. No significant correlation between fractional anisotropy for the ipsilateral cerebral peduncle and the Fugl-Meyer Motor Scale was found at week 12. Fractional anisotropy values for the ipsilateral hippocampus were related to the Montreal Cognitive Assessment and Mini-Mental State Examination at weeks 1 and 12. Deep supratentorial hemorrhage may result in injury to distal regions, which correlate with impaired motor and cognitive function.

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Metabolic changes in the ischemic penumbra after carotid endarterectomy in stroke patients by localized in vivo proton magnetic resonance spectroscopy (H-MRS)

Cited by 21 publications

References 26 publications

Metabolic changes in acute cerebral infarction: Findings from proton magnetic resonance spectroscopic imaging

Metabolic changes in acute cerebral infarction: Findings from proton magnetic resonance spectroscopic imaging

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Secondary injury to distal regions after intracerebral hemorrhage influence neurological functional outcome

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