Magnetic Resonance Spectroscopy: Basic Principles and Application in White Matter Disorders

Knaap, Marjo S. van der; Pouwels, Petra J. W.

doi:10.1007/3-540-27660-2_108

Cited by 10 publications

(12 citation statements)

References 237 publications

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“…Total scan time was around 8 min. N-acetylaspartate (NAA) peak areas were analyzed bilaterally in the 12 voxels corresponding to the centrum semiovale, with exclusion of voxels including lesions, and expressed as ratios to Cr, which is assumed to be relatively stable [17] ( Figure 2 ). …”

Section: Methodsmentioning

confidence: 99%

Reduced Creatine Kinase B Activity in Multiple Sclerosis Normal Appearing White Matter

et al. 2010

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BackgroundTwo studies using 31P-magnetic resonance spectroscopy (MRS) reported enhanced phosphocreatine (PCr) levels in normal appearing white matter (NAWM) of subjects with multiple sclerosis (MS), but this finding could not be properly explained.Methodology/Principal FindingsWe performed 31P-MRS and 1H-MRS in the NAWM in 36 subjects, including 17 with progressive MS, 9 with benign MS, and 10 healthy controls. Compared to controls, PCr/β-ATP and PCr/total 31P ratios were significantly increased in subjects with progressive MS, but not with benign MS. There was no correlation between PCr ratios and the N-acetylaspartate/creatine ratio, suggesting that elevated PCr levels in NAWM were not secondary to axonal loss. In the central nervous system, PCr is degraded by creatine kinase B (CK-B), which in the white matter is confined to astrocytes. In homogenates of NAWM from 10 subjects with progressive MS and 10 controls without central nervous system disease, we measured CK-B levels with an ELISA, and measured its activity with an enzymatic assay kit. Compared to controls, both CK-B levels and activity were decreased in subjects with MS (22.41 versus 46.28 µg/ml; p = 0.0007, and 2.89 versus 7.76 U/l; p<0.0001).Conclusions/SignificanceOur results suggest that PCr metabolism in the NAWM in MS is impaired due to decreased CK-B levels. Our findings raise the possibility that a defective PCr metabolism in astrocytes might contribute to the degeneration of oligodendrocytes and axons in MS.

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Section: Methodsmentioning

confidence: 99%

Reduced Creatine Kinase B Activity in Multiple Sclerosis Normal Appearing White Matter

et al. 2010

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“…Metabolites that can be detected in the human brain through 1 H‐MRS include N‐acetylaspartate (NAA), choline (Cho), creatine (Cr), myo ‐inositol (mI), and lactate. NAA is a marker of neuronal activity; Cho is primarily related to the synthesis and breakdown of membrane phospholipids; the Cr peak is related to energy production and storage; mI is a regulator of brain osmotic balance, a precursor for phosphoinositides involved in the second messenger system, and a glial marker; and lactate serves as an energy substrate for neurons under specific circumstances 4–7 …”

Section: Introductionmentioning

confidence: 99%

“…NAA is a marker of neuronal activity; Cho is primarily related to the synthesis and breakdown of mem-brane phospholipids; the Cr peak is related to energy production and storage; mI is a regulator of brain osmotic balance, a precursor for phosphoinositides involved in the second messenger system, and a glial marker; and lactate serves as an energy substrate for neurons under specific circumstances. [4][5][6][7] Previous studies have investigated the 1 H-MRS findings in patients with autism, demonstrating conflicting results. [8][9][10][11][12][13] Since these studies have investigated different patient populations and 1 H-MRS techniques, it is difficult to draw definitive conclusions regarding the metabolic abnormalities in patients with autism.…”

Section: Introductionmentioning

confidence: 99%

Proton Magnetic Resonance Spectroscopy in School‐Aged Autistic Children

Vasconcelos

Brito

Domingues

et al. 2008

Journal of Neuroimaging

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“…MR spectroscopy has proved clinically useful in neonates suspected of having metabolic disorders (79-81) owing to the unique ability to noninvasively detect the metabolic defect in vivo (82-85). For example, the presence of pyruvate (plus Lac and/ or alanine) and succinate are early indicators of pyruvate and succinate dehydrogenase complex deficiencies, respectively (79,(86)(87)(88). Detection of elevated glycine, in particular at long TEs, is clinically diagnostic in nonketotic hyperglycinemia (82), although intracerebral hemorrhage presents a confound in the interpretation of high glycine levels (89).…”

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confidence: 99%

Clinical Proton MR Spectroscopy in Central Nervous System Disorders

Öz¹,

Alger²,

Barker³

et al. 2014

Radiology

559

356

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A large body of published work shows that proton (hydrogen 1 [ 1 H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors present a summary of brain disorders in which MR spectroscopy has an impact on patient management, together with a critical consideration of common data acquisition and processing procedures. The article documents the impact of 1 H MR spectroscopy in the clinical evaluation of disorders of the central nervous system. The clinical usefulness of 1 H MR spectroscopy has been established for brain neoplasms, neonatal and pediatric disorders (hypoxia-ischemia, inherited metabolic diseases, and traumatic brain injury), demyelinating disorders, and infectious brain lesions. The growing list of disorders for which 1 H MR spectroscopy may contribute to patient management extends to neurodegenerative diseases, epilepsy, and stroke. To facilitate expanded clinical acceptance and standardization of MR spectroscopy methodology, guidelines are provided for data acquisition and analysis, quality assessment, and interpretation. Finally, the authors offer recommendations to expedite the use of robust MR spectroscopy methodology in the clinical setting, including incorporation of technical advances on clinical units.q RSNA, 2014 Online supplemental material is available for this article. G.O. (e-mail: gulin@cmrr.umn.edu). 2 The complete list of authors and affiliations is at the end of this article.q RSNA, 2014 Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. Radiology H MR Spectrum of the Brain: Metabolites and Their Biomarker PotentialMR spectroscopy provides a very different basic "readout" than MR imaging, namely a spectrum rather than an techniques were developed. These early localization techniques included pointresolved spectroscopy (PRESS) (1,2) and stimulated echo acquisition mode (STEAM) (3), methods that are now widely used in clinical MR spectroscopy applications.Preliminary studies revealed large differences in metabolite levels in acute stroke (4), chronic multiple sclerosis (5), and brain tumors compared with healthy brain (6). Although this work stimulated a surge of interest in 1 H MR spectroscopy for diagnosing and assessing CNS disorders during the early days of the "Decade of the Brain" (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999), many suboptimal patient studies (7) and the lack of consistent guidelines have led to a situation where, 20 years later, MR spectroscopy is still considered an "investigational technique" by some medical professionals and health care organizations. However, the ability to make an early, noninvasive diagnosis or to increase confidence in a suspected diagnosis is highly valued by patients and clinicians alike. As a result, an increasing number of imaging centers are incorporating MR spectroscopy into their clinical protocols for brain...

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Magnetic Resonance Spectroscopy: Basic Principles and Application in White Matter Disorders

Cited by 10 publications

References 237 publications

Reduced Creatine Kinase B Activity in Multiple Sclerosis Normal Appearing White Matter

Reduced Creatine Kinase B Activity in Multiple Sclerosis Normal Appearing White Matter

Proton Magnetic Resonance Spectroscopy in School‐Aged Autistic Children

Clinical Proton MR Spectroscopy in Central Nervous System Disorders

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