Spectroscopy Evidence of Diffuse Brain Abnormalities in Patients with Epileptogenic Foci

Castillo, Maurício

doi:10.3174/ajnr.a0715

Cited by 1 publication

(1 citation statement)

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“…As such, alterations in its concentration may be indicative of imbalance in neurotransmission anddisruption of any, or all, of these activities could conceivably lead to fatigue (Ronnback and Hansson 2004). Also, higher Glx/ NAA levels have been previously reported in epilepsy patients where these higher levels have been interpreted as a marker of elevated neural activity, although the exact pathophysiology is unclear (Castillo 2007; Savic et al 2000). Consequently, it is possible that the increased Glx/NAA ratio may be related to overburdened or heightened sensory processing of bodily sensations leading to fatigue, although further research is needed to better understand these findings.…”

Section: Discussionmentioning

confidence: 96%

Preliminary differences in peripheral immune markers and brain metabolites between fatigued and non-fatigued breast cancer survivors: a pilot study

Zick

Zwickey

Wood

et al. 2013

Brain Imaging and Behavior

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Persistent cancer-related fatigue (PCRF) is one of the most troubling side-effects of breast cancer (BC) treatment. One explanatory model for PCRF is sickness behavior, which is a set of adaptive responses including sleepiness and depressed mood in reaction to an inflammatory trigger. Prior research has investigated differences in inflammatory cytokines between fatigued and non-fatigued BC survivors, but no study has examined differences in brain metabolites. Differences in inflammatory markers, and brain metabolites using proton magnetic resonance spectroscopy were evaluated within 16 fatigued and 13 non-fatigued BC survivors. Fatigued BC survivors had significantly higher ratios of two markers derived from brain metabolites; namely (a) creatine, normalized to total creatine (creatine + phosphocreatine (Cr/tCr)) ratio (P = 0.03) and (b) glutamate + glutamine (Glx) to N-acetyl-aspartate (NAA) ratio (P = 0.01) in the posterior insula compared to non-fatigued breast cancer survivor. Further, serum IL-6 was increased in fatigued women compared to non-fatigued women (P = 0.03), Using receiver operator curves (ROC) we determined that the posterior insula Glx/NAA ratio was the best predictor of fatigue with an overall area under the receiver operating characteristic curve (AUROC) of 79%, with a sensitivity of 81% and a specificity of 69%. However, posterior insula Glx/NAA, Cr/tCr and serum IL-6 were not significantly correlated with one another implying the possibility of independent biological mechanisms for PCRF rather than an interrelated mechanism as represented by the sickness behavior model. This study provides novel preliminary evidence of several distinct neurobiological changes in the posterior insula associated with PCRF in BC survivors. Future, longitudinal studies are needed to explore these distinct biological phenomena where changes through time in peripheral immune markers and brain metabolites are examined to determine if they correlate with changes in fatigue.

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Section: Discussionmentioning

confidence: 96%