Cerebral Energy Status and Altered Metabolism in Early Brain Injury After Aneurysmal Subarachnoid Hemorrhage: A Prospective 31P-MRS Pilot Study
Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a mole...
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| Published in: | Frontiers in neurology Vol. 13; p. 831537 |
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| Abstract | Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of both primary and secondary changes.
The aim of this pilot study was to evaluate the feasibility and the diagnostic potential of early 31P-MRS in aSAH.
Patients with aSAH treated for ruptured aneurysms between July 2016 and October 2017 were prospectively included in the study. 3-Tesla-MRI including 31P-MRS was performed within the first 72 h after hemorrhage. Data of the vascular territories of the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) and the basal ganglia were separately analyzed and compared with data of a healthy age- and sex-matched control group. Phosphorous compound metabolites were quantified, and ratios of these metabolites were further evaluated. Influence of treatment modality, clinical conditions, and analgosedation were analyzed.
Data of 13 patients were analyzed. 31P-MRS showed significant changes in cerebral energy metabolism after aSAH in all cerebrovascular territories. Both PCr/ATP and PCr/Pi ratio were notably increased (
< 0.001). Also, Pi/ATP was significantly decreased in all cerebrovascular territories (
= 0.014). PME/PDE ratio was overall significant decreased (
< 0.001).
31P-MRS is a promising non-invasive imaging tool for the assessment of changes in energy metabolism after aSAH. It allows a detailed insight into EBI and seems to harbor a high potential for clinical practice. |
|---|---|
| AbstractList | Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of both primary and secondary changes.
The aim of this pilot study was to evaluate the feasibility and the diagnostic potential of early 31P-MRS in aSAH.
Patients with aSAH treated for ruptured aneurysms between July 2016 and October 2017 were prospectively included in the study. 3-Tesla-MRI including 31P-MRS was performed within the first 72 h after hemorrhage. Data of the vascular territories of the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) and the basal ganglia were separately analyzed and compared with data of a healthy age- and sex-matched control group. Phosphorous compound metabolites were quantified, and ratios of these metabolites were further evaluated. Influence of treatment modality, clinical conditions, and analgosedation were analyzed.
Data of 13 patients were analyzed. 31P-MRS showed significant changes in cerebral energy metabolism after aSAH in all cerebrovascular territories. Both PCr/ATP and PCr/Pi ratio were notably increased (
< 0.001). Also, Pi/ATP was significantly decreased in all cerebrovascular territories (
= 0.014). PME/PDE ratio was overall significant decreased (
< 0.001).
31P-MRS is a promising non-invasive imaging tool for the assessment of changes in energy metabolism after aSAH. It allows a detailed insight into EBI and seems to harbor a high potential for clinical practice. BackgroundAcute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of both primary and secondary changes.ObjectiveThe aim of this pilot study was to evaluate the feasibility and the diagnostic potential of early 31P-MRS in aSAH.MethodsPatients with aSAH treated for ruptured aneurysms between July 2016 and October 2017 were prospectively included in the study. 3-Tesla-MRI including 31P-MRS was performed within the first 72 h after hemorrhage. Data of the vascular territories of the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) and the basal ganglia were separately analyzed and compared with data of a healthy age- and sex-matched control group. Phosphorous compound metabolites were quantified, and ratios of these metabolites were further evaluated. Influence of treatment modality, clinical conditions, and analgosedation were analyzed.ResultsData of 13 patients were analyzed. 31P-MRS showed significant changes in cerebral energy metabolism after aSAH in all cerebrovascular territories. Both PCr/ATP and PCr/Pi ratio were notably increased (P < 0.001). Also, Pi/ATP was significantly decreased in all cerebrovascular territories (P = 0.014). PME/PDE ratio was overall significant decreased (P < 0.001).Conclusion31P-MRS is a promising non-invasive imaging tool for the assessment of changes in energy metabolism after aSAH. It allows a detailed insight into EBI and seems to harbor a high potential for clinical practice. Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of both primary and secondary changes.BackgroundAcute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall neurological outcome. However, direct detection of these alterations is limited. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of both primary and secondary changes.The aim of this pilot study was to evaluate the feasibility and the diagnostic potential of early 31P-MRS in aSAH.ObjectiveThe aim of this pilot study was to evaluate the feasibility and the diagnostic potential of early 31P-MRS in aSAH.Patients with aSAH treated for ruptured aneurysms between July 2016 and October 2017 were prospectively included in the study. 3-Tesla-MRI including 31P-MRS was performed within the first 72 h after hemorrhage. Data of the vascular territories of the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) and the basal ganglia were separately analyzed and compared with data of a healthy age- and sex-matched control group. Phosphorous compound metabolites were quantified, and ratios of these metabolites were further evaluated. Influence of treatment modality, clinical conditions, and analgosedation were analyzed.MethodsPatients with aSAH treated for ruptured aneurysms between July 2016 and October 2017 were prospectively included in the study. 3-Tesla-MRI including 31P-MRS was performed within the first 72 h after hemorrhage. Data of the vascular territories of the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) and the basal ganglia were separately analyzed and compared with data of a healthy age- and sex-matched control group. Phosphorous compound metabolites were quantified, and ratios of these metabolites were further evaluated. Influence of treatment modality, clinical conditions, and analgosedation were analyzed.Data of 13 patients were analyzed. 31P-MRS showed significant changes in cerebral energy metabolism after aSAH in all cerebrovascular territories. Both PCr/ATP and PCr/Pi ratio were notably increased (P < 0.001). Also, Pi/ATP was significantly decreased in all cerebrovascular territories (P = 0.014). PME/PDE ratio was overall significant decreased (P < 0.001).ResultsData of 13 patients were analyzed. 31P-MRS showed significant changes in cerebral energy metabolism after aSAH in all cerebrovascular territories. Both PCr/ATP and PCr/Pi ratio were notably increased (P < 0.001). Also, Pi/ATP was significantly decreased in all cerebrovascular territories (P = 0.014). PME/PDE ratio was overall significant decreased (P < 0.001).31P-MRS is a promising non-invasive imaging tool for the assessment of changes in energy metabolism after aSAH. It allows a detailed insight into EBI and seems to harbor a high potential for clinical practice.Conclusion31P-MRS is a promising non-invasive imaging tool for the assessment of changes in energy metabolism after aSAH. It allows a detailed insight into EBI and seems to harbor a high potential for clinical practice. |
| Author | Luger, Markus Steiger, Ruth Grams, Astrid Ellen Gizewski, Elke Ruth Rietzler, Andreas Ho, Wing Mann Treichl, Stephanie Alice Thomé, Claudius Petr, Ondra |
| AuthorAffiliation | 3 Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck , Innsbruck , Austria 1 Department of Neurosurgery, Medical University of Innsbruck , Innsbruck , Austria 4 Neuroimaging Research Core Facility, Medical University of Innsbruck , Innsbruck , Austria 2 Department of Neuroradiology, Medical University of Innsbruck , Innsbruck , Austria |
| AuthorAffiliation_xml | – name: 3 Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck , Innsbruck , Austria – name: 2 Department of Neuroradiology, Medical University of Innsbruck , Innsbruck , Austria – name: 1 Department of Neurosurgery, Medical University of Innsbruck , Innsbruck , Austria – name: 4 Neuroimaging Research Core Facility, Medical University of Innsbruck , Innsbruck , Austria |
| Author_xml | – sequence: 1 givenname: Stephanie Alice surname: Treichl fullname: Treichl, Stephanie Alice – sequence: 2 givenname: Wing Mann surname: Ho fullname: Ho, Wing Mann – sequence: 3 givenname: Ruth surname: Steiger fullname: Steiger, Ruth – sequence: 4 givenname: Astrid Ellen surname: Grams fullname: Grams, Astrid Ellen – sequence: 5 givenname: Andreas surname: Rietzler fullname: Rietzler, Andreas – sequence: 6 givenname: Markus surname: Luger fullname: Luger, Markus – sequence: 7 givenname: Elke Ruth surname: Gizewski fullname: Gizewski, Elke Ruth – sequence: 8 givenname: Claudius surname: Thomé fullname: Thomé, Claudius – sequence: 9 givenname: Ondra surname: Petr fullname: Petr, Ondra |
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| Cites_doi | 10.1016/s0021-9258(19)35418-3 10.1007/s12975-013-0257-2 10.1089/neu.2009.0924 10.3171/2017.8.focus17450 10.1155/2018/7806395 10.1089/neu.2014.3505 10.21037/qims.2017.11.03 10.3389/fneur.2017.00426 10.1097/mcc.0b013e32835132a5 10.1176/jnp.10.2.133 10.1006/jmre.1997.1244 10.1007/s12028-013-9884-4 10.3171/jns.1993.78.1.0112 10.1002/1099-1492(200005)13:3<154::aid-nbm620>3.0.co;2-w 10.1007/s12028-020-01042-x 10.1002/mrm.20312 10.1007/s10143-017-0827-y 10.1042/bj2810021 10.1016/0006-8993(91)90755-k 10.1179/016164106x115008 10.3171/jns.1988.68.1.0129 10.1177/0271678x18799176 10.1016/s0735-1097(02)02160-5 10.1016/j.pscychresns.2013.06.011 10.1089/neu.1988.5.315 10.1159/000017471 10.1097/00004647-199701000-00007 10.1016/0741-8329(94)00072-7 10.1038/s41598-018-29255-3 10.1186/cc11513 10.1089/08977150151070838 10.3389/fneur.2020.00219 10.1089/neu.2021.0143 10.1111/bdi.12339 |
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| Keywords | brain metabolism energy status 31-P-MR-spectroscopy subarachnoid hemorrhage early brain injury |
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| Snippet | Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for overall... BackgroundAcute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) may play a crucial role for... |
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| SubjectTerms | 31-P-MR-spectroscopy brain metabolism early brain injury energy status Neurology subarachnoid hemorrhage |
| Title | Cerebral Energy Status and Altered Metabolism in Early Brain Injury After Aneurysmal Subarachnoid Hemorrhage: A Prospective 31P-MRS Pilot Study |
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| Volume | 13 |
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