Quantitative multivoxel 1H MR spectroscopy of the brain in children with acute liver failure

Sijens, Paul E.; Alkefaji, Heyder; Lunsing, Roelineke J.; Spronsen, Francjan J. van; Meiners, Linda C.; Oudkerk, Matthijs; Verkade, Henkjan J.

doi:10.1007/s00330-008-1049-z

Cited by 16 publications

(10 citation statements)

References 22 publications

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“…Though the direction of the relationships differed across regions, Glx tended to be negatively associated with cortical volume and positively associated with ventricular volume. These findings are consistent with previously reported associations between increased Glx and brain damage caused by chronic and acute hepatic encephalopathy, hypoxia, near drowning, and ornithine transcarbamylase deficiency (Binesh et al , 2006; Gropman and Batshaw, 2004; Kreis et al , 1996; Long et al , 2009; Sijens et al , 2008). Findings for other brain disorders have been mixed with regards to the direction of Glx effects.…”

Section: Discussionsupporting

confidence: 93%

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

et al. 2010

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Cerebral metabolite disturbances occur among human immunodeficiency virus (HIV)-infected people, and are thought to reflect neuropathology, including proinflammatory processes, and neuronal loss. HIV-associated cortical atrophy continues to occur, though its basis is not well understood, and the relationship of cerebral metabolic disturbance to structural brain abnormalities in HIV has not been well delineated. We hypothesized that metabolite disturbances would be associated with reduced cortical and subcortical volumes. Cerebral volumes were measured in 67 HIV-infected people, including 10 people with mild dementia (acquired immunodeficiency syndrome [AIDS] dimentia complex [ADC] stage >1) via automated magnetic resonance imaging (MRI) segmentation. Magnetic resonance spectroscopy (MRS) was used to measure levels of cerebral metabolites N-acetylaspartate (NAA), myo-inositol (MI), choline-containing compounds (Cho), glutamate/glutamine (Glx), and creatine (Cr) from three brain regions (frontal gray matter, frontal white matter, basal ganglia). Analyses were conducted to examine the associations between MRS and cerebral volumetric measures using both absolute and relative metabolite concentrations. NAA in the mid-frontal gray matter was most consistently associated with cortical (global, frontal, and parietal), ventricular, and caudate volumes based on analysis of absolute metabolite levels, whereas temporal lobe volume was associated with basal ganglia NAA and Glx, and Cho concentrations in the frontal cortex and basal ganglia. Hippocampal volume was associated with frontal white matter NAA, whereas thalamic volume was associated with both frontal white matter NAA and basal ganglia Glx. Analyses of relative metabolite concentrations (referenced to Cr) yielded weaker effects, although more metabolites were retained as significant predictors in the models than the analysis of absolute concentrations. These findings demonstrate that reduced cortical and subcortical volumes, which have been previously found to be linked to HIV status and history, are also strongly associated with the degree of cerebral metabolite disturbance observed via MRS. Reduced cortical and hippocampal volumes were most strongly associated with decreased NAA, though reduced Glx also tended to be associated with reduced cortical and subcortical volumes (caudate and thalamus) as well, suggesting both neuronal and glial disturbances. Interestingly, metabolite-volumetric relationships were not limited to the cortical region from which MRS was measured, possibly reflecting shared pathophysiological processes. The relationships between Cho and volumetric measures suggest a complicated relationship possibly related to the effects of inflammatory processes on brain volume. The findings demonstrate the relationship between MRI-derived measures of cerebral metabolite disturbances and structural brain integrity, which has implication in understanding HIV-associated neuropathological mechanisms.

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Section: Discussionsupporting

confidence: 93%

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Though the direction of the relationships differed across regions, Glx tended to be negatively associated with cortical volume and positively associated with ventricular volume. These findings are consistent with previously reported associations between increased Glx and brain damage caused by chronic and acute hepatic encephalopathy, hypoxia, near drowning, and ornithine transcarbamylase deficiency (Binesh et al, 2006;Gropman and Batshaw, 2004;Kreis et al, 1996;Long et al, 2009;Sijens et al, 2008). Findings for other brain disorders have been mixed with regards to the direction of Glx effects.…”

Section: Discussionsupporting

confidence: 91%

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

Cohen

Harezlak

Gongvatana

et al. 2010

Journal of NeuroVirology

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Cerebral metabolite disturbances occur among human immunodeficiency virus (HIV)-infected people, and are thought to reflect neuropathology, including proinflammatory processes, and neuronal loss. HIV-associated cortical atrophy continues to occur, though its basis is not well understood, and the relationship of cerebral metabolic disturbance to structural brain abnormalities in HIV has not been well delineated. We hypothesized that metabolite disturbances would be associated with reduced cortical and subcortical volumes. Cerebral volumes were measured in 67 HIV-infected people, including 10 people with mild dementia (acquired immunodeficiency syndrome [AIDS] Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript cerebral metabolites N-acetylaspartate (NAA), myo-inositol (MI), choline-containing compounds (Cho), glutamate/glutamine (Glx), and creatine (Cr) from three brain regions (frontal gray matter, frontal white matter, basal ganglia). Analyses were conducted to examine the associations between MRS and cerebral volumetric measures using both absolute and relative metabolite concentrations. NAA in the mid-frontal gray matter was most consistently associated with cortical (global, frontal, and parietal), ventricular, and caudate volumes based on analysis of absolute metabolite levels, whereas temporal lobe volume was associated with basal ganglia NAA and Glx, and Cho concentrations in the frontal cortex and basal ganglia. Hippocampal volume was associated with frontal white matter NAA, whereas thalamic volume was associated with both frontal white matter NAA and basal ganglia Glx. Analyses of relative metabolite concentrations (referenced to Cr) yielded weaker effects, although more metabolites were retained as significant predictors in the models than the analysis of absolute concentrations. These findings demonstrate that reduced cortical and subcortical volumes, which have been previously found to be linked to HIV status and history, are also strongly associated with the degree of cerebral metabolite disturbance observed via MRS. Reduced cortical and hippocampal volumes were most strongly associated with decreased NAA, though reduced Glx also tended to be associated with reduced cortical and subcortical volumes (caudate and thalamus) as well, suggesting both neuronal and glial disturbances. Interestingly, metabolite-volumetric relationships were not limited to the cortical region from which MRS was measured, possibly reflecting shared pathophysiological processes. The relationships between Cho and volumetric measures suggest a complicated relationship possibly related to the effects of inflammatory processes on brain volume. The findings demonstrate the relationship between MRI-derived measures of cerebral metabolite disturbances and structural brain integrity, which has implication in understanding HIV-associated neuropathological mechanisms.

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“…An increase in the glutamine/glutamate peak with a decrease in the myo-inositol and choline peaks can be detected on MR spectroscopy [54,55]. This increase of glutamine/ glutamate may be related to hepatic encephalopathy [56].…”

Section: Alcohol Withdrawal Syndromesmentioning

confidence: 97%

Alcohol-induced changes in the brain as assessed by MRI and CT

2009

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This review provides an overview of structural magnetic resonance imaging and computed tomography findings of direct and indirect alcohol-related toxic effects on the brain. In addition to ethanol-related changes to the brain, this article will also describe imaging findings in the acute setting of methanol and ethylene glycol poisoning. Alcohol will lead to brain atrophy, osmotic myelinolysis, Marchiafava-Bignami disease and, especially when related to malnutrition, may also cause Wernicke encephalopathy. Brain atrophy can be reversible if alcohol abuse is stopped. If not treated, Wernicke encephalopathy can lead to coma and death and an early diagnosis is important for immediate initiation of thiamine substitution. As clinical symptoms are often unspecific, the radiologist plays an important role in the detection of alcohol abuse and its related clinical conditions.

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Quantitative multivoxel 1H MR spectroscopy of the brain in children with acute liver failure

Cited by 16 publications

References 22 publications

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

Cerebral metabolite abnormalities in human immunodeficiency virus are associated with cortical and subcortical volumes

Alcohol-induced changes in the brain as assessed by MRI and CT

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