Justyna Kozub

Reduced prefrontal N-acetylaspartate in stroke patients with apathy

BACKGROUND Although substantial numbers of stroke patients suffer from apathy, its causes are still poorly understood. Previous studies suggest that dysfunction of the frontal lobes is implicated in the pathophysiology of motivation. Our aim was to investigate the association between proton magnetic resonance spectroscopy (H1-MRS) measurements in unaffected frontal lobes and apathy in a group of first-time stroke patients. METHODS 31 patients with a first-time ischemic stroke located outside the frontal lobes and 20 healthy subjects were included in the study. The authors performed single voxel H1-MRS in order to measure the N-acetylaspartate/creatine (NAA)/Cr, glutamate+glutamine (Glx)/Cr, choline (Cho)/Cr and myo-inositol (mI)/Cr ratios in the frontal lobes. Patients were assessed between days 7 and 12 post stroke. Diagnosis of apathy was made on the basis of clinical observation, interview and Apathy Scale. RESULTS 13 out of 31 patients (42%) demonstrated apathy. Patients with apathy had lower NAA/Cr ratios in the right frontal lobe than non-apathetic subjects. The patient group was divided into two subgroups: Those with left hemisphere strokes, and those with right hemisphere strokes. Of these subjects, significantly lowered NAA/Cr ratios were found in the right hemispheres of apathetic patients in the subgroup with left-sided brain lesions. CONCLUSIONS These findings point to the association between apathy and frontal lobe integrity, suggest different reactions of the hemispheres and indicate that changes in the NAA/Cr ratio are related to the apathy.

PH Measurements of the Brain Using Phosphorus Magnetic Resonance Spectroscopy ((31)PMRS) in Healthy Men - Comparison of Two Analysis Methods.

Summary Background Intracellular pH provides information on homeostatic mechanisms in neurons and glial cells. The aim of this study was to define pH of the brain of male volunteers using phosphorus magnetic resonance spectroscopy (31PMRS) and to compare two methods of calculating this value. Material/Methods In this study, 35 healthy, young, male volunteers (mean age: 25 years) were examined by 31PMRS in 1.5 T MR system (Signa Excite, GE). The FID CSI (Free Induction Decay Chemical Shift Imaging) sequence was used with the following parameters: TR=4000 ms, FA=90°, NEX=2. Volume of interest (VOI) was selected depending on the size of the volunteers’ brain (11–14 cm3, mean 11.53 cm3). Raw data were analyzed using SAGE (GE) software. Results Based on the chemical shift of peaks in the 31PMRS spectrum, intracellular pH was calculated using two equations. In both methods the mean pH was slightly alkaline (7.07 and 7.08). Results were compared with a t-test. Significant difference (p<0.05) was found between these two methods. Conclusions The 31PMRS method enables non-invasive in vivo measurements of pH. The choice of the calculation method is crucial for computing this value. Comparing the results obtained by different teams can be done in a fully credible way only if the calculations were performed using the same formula.

Evaluation of the brain pH using a phosphorus magnetic resonance spectroscopy technique – a comparison of women and men

ABSTRACT The aim of this study was to determine the reference value of pH in healthy women and men using the phosphorus magnetic resonance spectroscopy technique. The brains of 65 young volunteers were examined. The intracellular pH was calculated in the group of women and the group of men. In both groups, the average pH was slightly alkaline (respectively 7.10 ± 0.08 and 7.08 ± 0.12). No statistically significant sex difference in brain pH was found. Thus, in case if this method is used to estimate possible brain pathology in the young population, it is not needed to take the gender factor into consideration.

Brain Maturation—Differences in Biochemical Composition of Fetal and Child's Brain

ABSTRACT Introduction: The aim of this study was to evaluate differences in 1H MRS spectra of the brain of fetuses and children from 6 to 11 years of age. Material and methods: 21 healthy fetuses in the third trimester and 22 children were examined using the proton nuclear magnetic resonance. The relative metabolite concentrations to the sum of all metabolites were calculated. Results: In the 1H MRS spectra of the brain from fetuses and children, there are the same characteristic peaks: N-acetylaspartate (NAA), creatine (Cr), choline (Cho), and myo-inositol (mI). NAA/Σ, NAA/Cr, and Cr/Σ concentrations are significantly higher and Cho/Σ, Cho/Cr, mI/Σ, and mI/Cr are significantly lower in children than in the fetuses. Conclusions: It was found that the brain metabolism changes from fetal life to childhood. The results of this study may provide a valuable basis for further research on brain maturation and “healthy aging.”

Differences in Metabolite Concentrations Between the Hemispheres of the Brain in Healthy Children A Proton Magnetic Resonance Spectroscopy Study (1HMRS)

The aim of this 1HMRS study was to identify hemispheric asymmetries in metabolismus in healthy children. The study group consisted of children of both sexes aged 6 to 15. Concentrations of 6 metabolites occurring in the brain were determined for 6 locations: hippocampus, frontal lobe, and basal ganglia in the left and right hemispheres. There were no hemispheric differences in the metabolites’ concentrations in the brain in children when the variable of sex was disregarded. Only in the group of boys and in the group of girls did the findings show few discrepancies. In none of these groups, relative concentrations to creatine concentration were found to be significantly different between hemispheres. In clinical practice, concentrations of specific metabolites are most frequently determined relative to the concentration of creatine. Consequently, the analysis of standard 1HMRS examinations in children does not need to take into account interhemispheric differences.

Sex differences in brain metabolite concentrations in healthy children – proton magnetic resonance spectroscopy study ( 1 HMRS)

Purpose The aim of this 1HMRS study was to define sex-related differences in metabolic spectrum between healthy children. Forty-nine girls and boys aged 6-15 years were examined. Material and methods Volume of interest was located in seven brain regions: frontal lobes, basal ganglia, hippocampi, and cerebellum. Results Statistical analysis of the results showed significantly higher (p < 0.05) myo-inositol concentrations relative to the total concentrations in the boys than the girls, as well as higher absolute N-acetyl aspartate concentrations in the left frontal lobes in girls. No other significant differences were shown, except for trends in differences. Conclusions In clinical practice the diagnostic process first of all focuses on assessing concentrations of metabolites to relative cerebellum concentration. Thus, the findings of the present study allow the conclusion that when analysing the results of 1HMRS studies in children it is not necessary to take into account the child’s gender.

Evaluation of changes in biochemical composition of fetal brain between 18th and 40th gestational week in proton magnetic resonance spectroscopy

Abstract Introduction: The aim of this study is to determine the right 1H MRS spectra of the brain in fetuses of different age, and then to define what metabolic changes occur between 18th and 40th weeks of pregnancy. Methods: 1H MRS studies of 32 fetuses aged 18–40 gestational weeks were performed, in which the MRI excluded central nervous system malformations. The studied group included 11 fetuses aged 18–25 weeks (the second half of the second trimester), 14 fetuses aged 26–33 weeks (the first half of the third trimester), and seven fetuses aged 34–40 weeks (the second half of the third trimester). The relative ratios of metabolites concentrations to the sum of all metabolites were calculated. Results: Increase in the concentrations of N-acetylaspartate (NAA), Cr, Cho, and myo-inositol (mI) with gestational age is statistically significant. Only increase in Glx is statistically insignificant. In the analyzed period of pregnancy also, an insignificant increase of NAA/Σ and Cr/Σ ratios and a decrease of mI/Σ, Cho/Σ and Glx/Σ ratios were noticed. Conclusions: Changes in the 1H MRS spectrum are visible with increasing age of the fetus. All studied substances in fetal brain change their concentrations during pregnancy, which may be associated with the synaptic and dendritic development as well as myelination. Knowledge about the chemical changes in the fetal brain can provide valuable information in studies of the mechanisms of pregnancy and fetal development, define steps of brain metabolic development and explain reasons of pathologies.

Brain aging: Evaluation of pH using phosphorus magnetic resonance spectroscopy: Brain aging: Evaluation of pH

Very important aspects of aging include age‐related changes occurring in the brain. The aim of the present study was to identify the standard pH value in the entire brain volume using phosphorus magnetic resonance spectroscopy in healthy individuals of both sexes in different age groups, and then to determine whether there are differences in these values.