Nicholas N. Kuzma

Dietary Therapy Mitigates Persistent Wake Deficits Caused by Mild Traumatic Brain Injury

Mild traumatic brain injury causes persistent deficits in wakefulness in mice, which are mitigated by a dietary therapy containing branched-chain amino acids. A Diet for Staying Awake Postconcussive syndrome can persist for months after mild traumatic brain injury (TBI), and includes debilitating neurological symptoms such as sleep-wake disturbances. Sleep disorders can hinder recovery from brain injury by exacerbating existing deficits in memory, cognition, and daily functioning. No proven therapies exist to mitigate the sequelae of TBI. Now, Lim et al. show that mild TBI in mice causes a persistent inability to maintain wakefulness and is associated with decreased activation of orexin neurons. Orexin is involved in human narcolepsy and other disorders of arousal. Lim et al. gave mice with TBI a dietary supplement of branched-chain amino acids (BCAA), precursors for de novo glutamate synthesis in the brain. BCAA therapy restored activation of orexin neurons and improved wakefulness in injured mice. These data suggest that dietary BCAA intervention, acting in part through orexin, can improve sleep-wake dysfunction after TBI and may potentially facilitate recovery of function from brain injury. Sleep disorders are highly prevalent in patients with traumatic brain injury (TBI) and can significantly impair cognitive rehabilitation. No proven therapies exist to mitigate the neurocognitive consequences of TBI. We show that mild brain injury in mice causes a persistent inability to maintain wakefulness and decreases orexin neuron activation during wakefulness. We gave mice a dietary supplement of branched-chain amino acids (BCAAs), precursors for de novo glutamate synthesis in the brain. BCAA therapy reinstated activation of orexin neurons and improved wake deficits in mice with mild brain injury. Our data suggest that dietary BCAA intervention, acting in part through orexin, can ameliorate injury-induced sleep disturbances and may facilitate cognitive rehabilitation after brain injury.

Imaging the interaction of atelectasis and overdistension in surfactant-depleted lungs.

Objective:Atelectasis and surfactant depletion may contribute to greater distension—and thereby injury—of aerated lung regions; recruitment of atelectatic lung may protect these regions by attenuating such overdistension. However, the effects of atelectasis (and recruitment) on aerated airspaces remain elusive. We tested the hypothesis that during mechanical ventilation, surfactant depletion increases the dimensions of aerated airspaces and that lung recruitment reverses these changes. Design:Prospective imaging study in an animal model. Setting:Research imaging facility. Subjects:Twenty-seven healthy Sprague Dawley rats. InterventionsSurfactant depletion was obtained by saline lavage in anesthetized, ventilated rats. Alveolar recruitment was accomplished using positive end-expiratory pressure and exogenous surfactant administration. Measurements and Main Results:Airspace dimensions were estimated by measuring the apparent diffusion coefficient of 3He, using diffusion-weighted hyperpolarized gas magnetic resonance imaging. Atelectasis was demonstrated using computerized tomography and by measuring oxygenation. Saline lavage increased atelectasis (increase in nonaerated tissue from 1.2% to 13.8% of imaged area, p < 0.001), and produced a concomitant increase in mean apparent diffusion coefficient (~33%, p < 0.001) vs. baseline; the heterogeneity of the computerized tomography signal and the variance of apparent diffusion coefficient were also increased. Application of positive end-expiratory pressure and surfactant reduced the mean apparent diffusion coefficient (~23%, p < 0.001), and its variance, in parallel to alveolar recruitment (i.e., less computerized tomography densities and heterogeneity, increased oxygenation). Conclusions:Overdistension of aerated lung occurs during atelectasis is detectable using clinically relevant magnetic resonance imaging technology, and could be a key factor in the generation of lung injury during mechanical ventilation. Lung recruitment by higher positive end-expiratory pressure and surfactant administration reduces airspace distension.

Measurements of the persistent singlet state of N2O in blood and other solvents—Potential as a magnetic tracer

The development of hyperpolarized tracers has been limited by short nuclear polarization lifetimes. The dominant relaxation mechanism for many hyperpolarized agents in solution arises from intramolecular nuclear dipole–dipole coupling modulated by molecular motion. It has been previously demonstrated that nuclear spin relaxation due to this mechanism can be removed by storing the nuclear polarization in long‐lived, singlet‐like states. In the case of N2O, storing the polarization of the nitrogen nuclei has been shown to substantially increase the polarization lifetime. The feasibility of utilizing N2O as a tracer is investigated by measuring the singlet‐state lifetime of the N2O when dissolved in a variety of solvents including whole blood. Comparison of the singlet lifetime to longitudinal relaxation and between protonated and deuterated solvents is consistent with the dominance of spin‐rotation relaxation, except in the case of blood. Magn Reson Med, 2011.

A multislice single breath-hold scheme for imaging alveolar oxygen tension in humans

Reliable, noninvasive, and high‐resolution imaging of alveolar partial pressure of oxygen (pAO2) is a potentially valuable tool in the early diagnosis of pulmonary diseases. Several techniques have been proposed for regional measurement of pAO2 based on the increased depolarization rate of hyperpolarized 3He. In this study, we explore one such technique by applying a multislice pAO2‐imaging scheme that uses interleaved‐slice ordering to utilize interslice time‐delays more efficiently. This approach addresses the low spatial resolution and long breath‐hold requirements of earlier techniques, allowing pAO2 measurements to be made over the entire human lung in 10–15 s with a typical resolution of 8.3 × 8.3 × 15.6 mm3. PO2 measurements in a glass syringe phantom were in agreement with independent gas analysis within 4.7 ± 4.1% (R = 0.9993). The technique is demonstrated in four human subjects (healthy nonsmoker, healthy former smoker, healthy smoker, and patient with COPD), each imaged six times on 3 different days during a 2‐week span. Two independent measurements were performed in each session, consisting of 12 coronal slices. The overall pAO2 mean across all subjects was 95.9 ± 12.2 Torr and correlated well with end‐tidal O2 (R = 0.805, P < 0.0001). The alveolar O2 uptake rate was consistent with the expected range of 1–2 Torr/s. Repeatable visual features were observed in pAO2 maps over different days, as were characteristic differences among the subjects and gravity‐dependent effects. Magn Reson Med, 2012.

Metabolism of hyperpolarized [1-13C]pyruvate in the isolated perfused rat lung – an ischemia study

We report studies of the effect of ischemia on the metabolic activity of the intact perfused lung and its restoration after a period of reperfusion. Two groups of rat lungs were studied using hyperpolarized 1‐13C pyruvate to compare the rate of lactate labeling differing only in the temporal ordering of ischemic and normoxic acquisitions. In both cases, a several‐fold increase in lactate labeling was observed immediately after a 25‐min ischemia event as was its reversal back to the baseline after 30–40 min of resumed perfusion (n = 5, p < 0.025 for both comparisons). These results were corroborated by 31P spectroscopy and correspond well to measured changes in lactate pool size determined by 1H spectroscopy of freeze‐clamped specimens. Copyright

Cluster formation restricts dynamic nuclear polarization of xenon in solid mixtures

During dynamic nuclear polarization (DNP) at 1.5 K and 5 T, (129)Xe nuclear magnetic resonance (NMR) spectra of a homogeneous xenon/1-propanol/trityl-radical solid mixture exhibit a single peak, broadened by (1)H neighbors. A second peak appears upon annealing for several hours at 125 K. Its characteristic width and chemical shift indicate the presence of spontaneously formed pure Xe clusters. Microwave irradiation at the appropriate frequencies can bring both peaks to either positive or negative polarization. The peculiar time evolution of (129)Xe polarization in pure Xe clusters during DNP can be modelled as an interplay of spin diffusion and T(1) relaxation. Our simple spherical-cluster model offers a sensitive tool to evaluate major DNP parameters in situ, revealing a severe spin-diffusion bottleneck at the cluster boundaries and a significant sample overheating due to microwave irradiation. Subsequent DNP system modifications designed to reduce the overheating resulted in four-fold increase of (129)Xe polarization, from 5.3% to 21%.

Regional function-structure relationships in lungs of an elastase murine model of emphysema

Changes in lung function and structure were studied using hyperpolarized (3)He MRI in an elastase-induced murine model of emphysema. The combined analysis of the apparent diffusion coefficient (ADC) and fractional ventilation (R) were used to distinguish emphysematous changes and also to develop a model for classifying sections of the lung into diseased and normal. Twelve healthy male BALB/c mice (26 ± 2 g) were randomized into healthy and elastase-induced mice and studied ∼8-11 wk after model induction. ADC and R were measured at a submillimeter planar resolution. Chord length (L(x)) data were analyzed from histology samples from the corresponding imaged slices. Logistic regression was applied to estimate the probability that an imaged pixel came from a diseased animal, and bootstrap methods (1,000 samples) were used to compare the regression results for the morphological and imaging results. Multivariate ANOVA (MANOVA) was used to analyze transformed ADC (ADC(BC)), and R (R(BC)) data and also to control for the experiment-wide error rate. MANOVA and ANOVA showed that elastase induced a statistically measureable change in the average transformed L(x) and ADC(BC) but not in the average R(BC). Marginal mean analysis demonstrated that ADC(BC) was on average 0.19 [95% confidence interval (CI): 0.16, 0.22] higher in the emphysema group, whereas R(BC) was on average 0.05 (95% CI: 0.04, 0.06) lower. Logistic regression supported the hypothesis that ADC(BC) and R(BC), together, were better at differentiating normal from diseased tissue than either measurement alone. The odds ratios for ADC(BC) and R(BC) were 7.73 (95% CI: 5.23, 11.42) and 9.14 × 10(-5) (95% CI: 3.33 × 10(-5), 25.06 × 10(-5)), respectively. Using a 50% probability cutoff, this model classified 70.6% of pixels correctly. The sensitivity and specificity of this model at the 50% cutoff were 74.9% and 65.2%, respectively. The area under the receiver operating characteristic curve was 0.76 (95% CI: 0.74, 0.78). The regression model presented can be used to map MRI data to disease probability maps. These probability maps present a future possibility of using both measurements in a more clinically feasible method of diagnosing this disease.

A variability study of regional alveolar oxygen tension measurement in humans using hyperpolarized 3He MRI

A systematic study of the short‐term and long‐term variability of regional alveolar partial pressure of oxygen tension (pAO2) measurements using 3He magnetic resonance imaging was presented. Additionally, the repeatability of the average evaluated pAO2 was compared with that of the standard pulmonary function tests.

Propagation of dynamic nuclear polarization across the xenon cluster boundaries: Elucidation of the spin-diffusion bottleneck

Earlier Dynamic Nuclear Polarization (DNP) experiments with frozen xenon/1-propanol/trityl mixtures have demonstrated spontaneous formation of pure xenon clusters above 120 K, enabling spectrally-resolved real-time measurements of (129)Xe nuclear magnetization in the clusters and in the surrounding radical-rich matrix. A spin-diffusion bottleneck was postulated to explain the peculiar time evolution of (129)Xe signals in the clusters as well as the apparent discontinuity of (129)Xe polarization across the cluster boundaries. A self-contained ab initio model of nuclear spin diffusion in heterogeneous systems is developed here, incorporating the intrinsic T1 relaxation towards the temperature-dependent equilibrium polarization and the spin-diffusion coefficients based on the measured NMR line widths and the known atomic densities in each compartment. This simple model provides the physical basis for the observed spin-diffusion bottleneck and is in a good quantitative agreement with the earlier measurements. A simultaneous fit of the model to the time-dependent NMR data at two different DNP frequencies provides excellent estimates of the cluster size, the intrinsic sample temperature, and (129)Xe T1 constants. The model was also applied to the NMR data acquired during relaxation towards the thermal equilibrium after the microwaves were turned off, to estimate T1 relaxation time constants inside and outside the clusters. Fitting the model to the data during and after DNP provides consistent estimates of the cluster size.

Lineshape-based polarimetry of dynamically-polarized 15N2O in solid-state mixtures

Dynamic nuclear polarization (DNP) of (15)N2O, known for its long-lived singlet-state order at low magnetic field, is demonstrated in organic solvent/trityl mixtures at ∼1.5 K and 5 T. Both (15)N polarization and intermolecular dipolar broadening are strongly affected by the samples thermal history, indicating spontaneous formation of N2O clusters. In situ (15)N NMR reveals four distinct powder-pattern spectra, attributed to the chemical-shift anisotropy (CSA) tensors of the two (15)N nuclei, further split by the intramolecular dipolar coupling between their magnetic moments. (15)N polarization is estimated by fitting the free-induction decay (FID) signals to the analytical model of four single-quantum transitions. This analysis implies (10.2±2.2)% polarization after 37 h of DNP, and provides a direct, instantaneous probe of the absolute (15)N polarization, without a need for time-consuming referencing to a thermal-equilibrium NMR signal.