Understanding the mechanism of brain glucose transport across the blood-brain barrier is of importance to understanding brain energy metabolism. The specific kinetics of glucose transport have been generally described using standard Michaelis-Menten kinetics. These models predict that the steady-state glucose concentration approaches an upper limit in the human brain when the plasma glucose level is well above the Michaelis-Menten constant for half-maximal transport, K~. In experiments where steady-state plasma glucose content was varied from 4 to 30 mM, the brain glucose level was a linear function of plasma glucose concentration. At plasma concentrations nearing 30 mM, the brain glucose level approached 9 mM, which was significantly higher than predicted from the previously reported KÔf --'4 mM (p < 0.05). The high brain glucose concentration measured in the human brain suggests that ablumenal brain glucose may compete with lumenal glucose for transport. We developed a model based on a reversible MichaelisMenten kinetic formulation of unidirectional transport rates. Fitting this model to brain glucose level as a function of plasma glucose level gave a substantially lower KÔ f 0.6 ±2.0 mM, which was consistent with the previously reported millimolar Km of GLUT-i in erythrocyte model systems. Previously reported and reanalyzed quantification provided consistent kinetic parameters. We conclude that cerebral glucose transport is most consistently described when using reversible Michaelis-Men±en kinetics. Key Words: NMR-Glucose transport-ln vivo studies-Spectroscopy-Human. J. Neurochem. 70, 397-408 (1998).Knowledge of the specific mechanism of glucose transport across the blood-brain barrier is important for understanding cerebral carbohydrate metabolism, which is the major source of energy for ATP production. Glucose transport across the blood-brain barrier occurs by facilitated diffusion mediated by specific transporter proteins. Glucose extraction is a saturable process in the brain/ (Crone, 1965) and erythrocytes (Le Fevre, 1961)atid is mediated by facilitated diffusion that has been well-established to be stereospecific and substrate-specific. Standard Michaelis-Menten models for glucose transport kinetics have since been used almost exclusively in most studies of the brain (for reviews, see, e.g., Lund-Andersen, 1979;Pardridge, 1983;Gjedde, 1992), with one exception .Many elegant techniques have been applied to study brain glucose uptake. The indicator-dilution techniques sample tracer extraction with a single pass across the capillary bed at a very high time resolution but with a somewhat limited spatial resolution (Knudsen et al., 1990). On the other hand, state-of-the art tracer techniques, such as positron emission tomography (PET), can provide a high spatial resolution (Svarer et al., 1996). However, the information on cerebral glucose content is indirect because the active metabolism of labeled glucose implies substantial label accumulation in metabolic products that cannot be distinguished fr...