scholarly journals Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist

2019 ◽  
Vol 32 (6) ◽  
pp. 408-419 ◽  
Author(s):  
Nicolas Fayed ◽  
Barbara Oliván ◽  
Yolanda Lopez del Hoyo ◽  
Eva Andrés ◽  
Mari Cruz Perez-Yus ◽  
...  

The aims of this work were to evaluate whether the treatment of patients with fibromyalgia with memantine is associated with significant changes in metabolite concentrations in the brain, and to explore any changes in clinical outcome measures. Magnetic resonance spectroscopy was performed of the right anterior and posterior insula, both hippocampi and the posterior cingulate cortex. Questionnaires on pain, anxiety, depression, global function, quality of life and cognitive impairment were used. Ten patients were studied at baseline and after three months of treatment with memantine. Significant increases were observed in the following areas: N-acetylaspartate (4.47 at baseline vs. 4.71 at three months, p = 0.02) and N-acetylaspartate+N-acetylaspartate glutamate in the left hippocampus (5.89 vs. 5.98; p = 0.007); N-acetylaspartate+N-acetylaspartate glutamate in the right hippocampus (5.31 vs 5.79; p = 0.01) and the anterior insula (7.56 vs. 7.70; p = 0.033); glutamate+glutamine/creatine ratio in the anterior insula (2.03 vs. 2.17; p = 0.022) and the posterior insula (1.77 vs. 2.00; p = 0.004); choline/creatine ratio in the posterior cingulate (0.18 vs. 0.19; p = 0.023); and creatine in the right hippocampus (3.60 vs. 3.85; p = 0.007). At the three-month follow-up, memantine improved cognitive function assessed by the Cognition Mini-Exam (31.50, SD = 2.95 vs. 34.40, SD = 0.6; p = 0.005), depression measured by the Hamilton Depression Scale (7.70, SD = 0.81 vs. 7.56, SD = 0.68; p = 0.042) and severity of illness measured by the Clinical Global Impression severity scale (5.79, SD = 0.96 vs. 5.31, SD = 1.12; p = 0.007). Depression, clinical global impression and cognitive function showed improvement with memantine. Magnetic resonance spectroscopy could be useful in monitoring response to the pharmacological treatment of fibromyalgia.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Shigeru Owada ◽  
Aki Hirayama ◽  
Teruhiko Maeba

Abstract Background and Aims In Japan, the elderly population is increasing remarkably, and dialysis patients are aging as usual. According to statistics from the Japanese Society for Dialysis Therapy, at the end of 2017, the incidence of HD patients is estimated to be 3 per 1,000 population, and by the end of 2020, the average age will be over 70 years. Therefore, early diagnosis of cognitive impairment is an important issue. With the aging of dialysis patients, the number of cases showing cognitive dysfunction increase in addition to the decline of physical strength. The problem of the onset of dementia involves many difficulties in medical treatment and nursing. Magnetic resonance spectroscopy (MRS) has been progressing from 1970s to evaluate neurological functions by measuring metabolites in the brain non-invasively. There are few reports using MRS for dialysis patients. In this study, we investigated the brain metabolites of hemodialysis (HD) patients with or without cognitive impairments using MRS and evaluated its usefulness for the diagnosis of cognitive disorder. Method A Toshiba MR device of 1.5 T was used. PRESS sequence was used to acquire water-suppressed 1H-MRS. Timing was TR/TE 2000/25 ms. Three kinds of brain metabolites, namely N-acethylaspartate (NAA), creatine (Cr) and mioinositol (MI) in the posterior cingulate gyrus were measured for 25 healthy adults (Cont group, 44±16 y.o.) and 84 HD patients (HD group, 74±11 y.o.), and ratios of NAA/Cr, MI/Cr and MI/NAA were calculated. The concentration of each metabolite was analyzed using LC model. HD patients were classified into three groups, namely normal cognitive function group (HD-N, n=25, 72±16 y.o.), mild cognitive impairment (HD-M, n=29, 74±9 y.o.) and dementia (HD-D, n=30, 79±8 y.) using MMSE test. Also, sequential changes of the brain metabolites were evaluated for 13 patients with worse cognitive function prospectively. Results HD patients showed a significant decrease of NAA and increases of MI and MI/NAA ratios compared to those of Cont group, suggesting that some metabolic abnormalities were inducted in HD. With a detailed classification of cognitive function in HD patients, NAA/Cr ratios were 1.69±0.17, 1.57±0.15, 1.71±0.20 and 1.54±0.22 in Cont, HD-N, HD-M and HD-D groups, respectively, and was significantly lower even in HD-N group than that of Cont group. MI/Cr ratios were 0.78±0.21, 0.90±0.21, 0.95±0.28 and 1.02±0.27 in Cont, HD-N, HD-M and HD-D groups, respectively, and those of HD-N/-M/-D were significantly higher than that of Cont group. Also, the value of HD-D was significantly higher than those in the other groups. MI/NAA ratios were 0.46±0.13, 0.56±0.17, 0.54±0.16 and 0.66±0.15, in Cont, HD-N, HD-M and HD-D groups, respectively. Again, those of HD-N/-M/-D were significantly higher than that of Cont group. HD-D group was highest among the HD patients. In the prospective study, dementia progressed in 10 of 13 HD patients who were observed more than 5 years. The MI/NAA ratio increased in the patients with dementia progression (from 0.58±0.11 to 1.24±0.17) while that value of the patients without dementia progression showed no changes (from 0.51±0.14 to 0.55±0.18). Conclusion These result suggest that the measurement of metabolic fluctuation in the brain using MRS is useful for the diagnosis of cognitive function in HD patients. The MI/NAA value is a strong candidate for a predictive biomarker of dementia progression. In the future, research and development of measurements of various parts of the brain and their integration to show changes in the whole brain are desired.


2021 ◽  
Vol 12 (2) ◽  
pp. 36-40
Author(s):  
А. М. Sergeev ◽  
A. V. Pozdnyakov ◽  
E. E. Atamanova ◽  
O. F. Pozdnyakova ◽  
D. A. Malekov ◽  
...  

Introduction. Cognitive epileptiform disintegration is a complex of disorders of higher mental functions in a person with a pathological EEG pattern characteristic of epilepsy. In this case, the patient should not have epileptic seizures or a history of single seizures is allowed. The study of biomarkers of the pathological condition under consideration using proton magnetic resonance spectroscopy as indicators that can be objectively evaluated and measured determines the practical relevance of this work.The aim of the study was to determine the diagnostic significance of the metabolites of N-acetylaspartate, choline and creatine according to proton magnetic resonance spectroscopy in the brain of children with cognitive epileptiform disintegration. Material and methods. Using routine MRI and proton magnetic resonance spectroscopy, 6 children with a diagnosis of mental retardation, cognitive epileptiform disintegration at the age of 2 to 7 years (5 boys; 1 girl) were examined. The patients underwent EEG followed by identification of a typical QED pattern. All children had no history of seizures characteristic of epilepsy. Results. А decrease in the ratio of the concentration of NAA/Cr (p<0,05) in the temporal lobes on both sides and the hippocampus on the right was revealed, due to a decrease in the concentration of N-acetylaspartate. There is also an increase in the Cho/NAA concentration ratio (p<0,05) in the hippocampus on the right, and an increase in the Cho/Cr concentration ratio (p<0,05) in the prefrontal cortex, postcentral gyri on both sides, the temporal lobe on the right and the region of the inner capsule on the left, by increasing the concentration of choline. Conclusions. Тhe obtained data suggest that changes in neurometabolism in the cholinergic system in children with cognitive epileptiform disintegration are possibly caused by damage to neuronal connections, mainly in the hippocampus and temporal lobes.


Author(s):  
Direnç Özlem Aksoy ◽  
Alpay Alkan

Background: Neurometabolic diseases are a group of diseases secondary to disorders in different metabolic pathways, which lead to white and/or gray matter of the brain involvement. </P><P> Discussion: Neurometabolic disorders are divided in two groups as dysmyelinating and demyelinating diseases. Because of wide spectrum of these disorders, there are many different classifications of neurometabolic diseases. We used the classification according to brain involvement areas. In radiological evaluation, MRI provides useful information for these disseases. Conclusion: Magnetic Resonance Spectroscopy (MRS) provides additional metabolic information for diagnosis and follow ups in childhood with neurometabolic diseases.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marta Waliszewska-Prosół ◽  
Joanna Bladowska ◽  
Sławomir Budrewicz ◽  
Marek Sąsiadek ◽  
Edyta Dziadkowiak ◽  
...  

AbstractThyroid dysfunction is very often accompanied by cognitive and affective disorders. The frequency of these disorders in patients with compensated Hashimoto’s thyroiditis (HT) is unknown. The aim of the present study was to evaluate brain dysfunction in euthyroid HT patients by means of event-related potentials (ERP) and magnetic resonance spectroscopy (MRS) and to correlate it with cognitive function. 68 patients with HT (59 female, 9 male) and 45 healthy controls were included in the study. All the patients underwent ERP including an analysis of N200 and P300 response parameters. MRS voxels were located in the posterior cingulate gyrus (PCG) and the left parietal white matter (PWM). The NAA/Cr, mI/Cr, and Cho/Cr ratios were analysed. The ERP parameters, MRS metabolite ratios and hormonal concentrations (TSH, fT3, fT4) as well as TGAb and TPOAb titer were also correlated. There was a significant prolongation of the latencies of N200 and P300 potentials and a significant decrease of P300 amplitude in HT patients than in the control group. There was a significant positive correlation between the mI/Cr ratio in the PCG area and P300 latencies. NAA/Cr ratio in the PCG region showed significant negative correlations with all N200 latencies. The results may suggest brain dysfunction in neurologically asymptomatic HT patients. ERPs undergo significant changes in patients with HT and may, in combination with MRS, constitute an important element in the recognition and monitoring of cognitive functions in this group of patients.


2013 ◽  
Vol 74 (1) ◽  
pp. 183-190
Author(s):  
Senair Alberto Ambros ◽  
Paulo Belmonte Abreu ◽  
Eloísa Elena Ferreira ◽  
Pdro Eugenio Ferreira ◽  
Luciana Estacia Ambros

Objective: To assess the metabolic alterations of the thalamus in subjects with schizophrenia compared to healthysubjects and to investigate whether specific schizophrenic symptoms are associated with metabolic alterationsmeasured by 1H MRS. Methods: This is a case-control study including patients with schizophrenia diagnosed usingthe Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, DMS-IV and the Operational CriteriaChecklist for Psychotic Illness (OPCRIT). Proton magnetic resonance spectroscopy (1H MRS) was used to assessmetabolite concentrations (N-acetylaspartate, choline, creatinine, myoionositol and lactacte) in the left and rightthalamus of 13 patients with schizophrenia and 13 healthy controls. Results: In this study, concentrations ofspecific metabolites in the thalamus, determined by 1H MRS, were similar for individuals with schizophrenia andcontrols. It was observed that cases with family history of schizophrenia and disorganized speech demonstrated areduction in the ratio of the metabolites NAA /Cho in the thalamic nuclei on the right side. However, those withorganized delusions, hallucinations and non-affective auditory hallucinations had an increase of metabolites on theright side compared to the left thalamus. Decreased thalamic metabolic activity in patients with positive symptomswas observed in contrast with those who had well-organized delusions and auditory non-affective hallucinations,core symptoms of schizophrenia. Conclusion: A lateralized thalamic involvement was verified, suggesting thatorganic and genetic factors compromise the right thalamus and that the disorganization associated with delusionsand hallucinations compromises the left thalamic nuclei. Further studies to investigate the correlation betweensymptoms and thalamic dysfunction are warranted. (Rev Neuropsiquiatr 2011;74:183-190)


2018 ◽  
Vol 10 (1S) ◽  
pp. 51-55
Author(s):  
E. S. Solomatova ◽  
N. A. Shnaider ◽  
A. A. Molgachev ◽  
D. V. Dmitrenko ◽  
I. G. Strotskaya

The temporal lobe is the most epileptogenic region of the brain. 90% of patients with temporal ictal epileptomorphic EEG activity have a variable long history of seizures. Magnetic resonance spectroscopy  (MRS) may be useful in identifying an epileptogenic focus in patients  with epilepsy without apparent structural pathology at neuroimaging.Objective: to systematize the results of early studies on this issue.Materials and methods. An electronic search was carried out in two English-language (Medline, PubMed) and one Russian-language (eLIBRARY.RU) databases. The search queries found  18,019 citations, by which 12 full-text articles were selected.Results and discussion. The main criteria for the diagnosis of temporal lobe epilepsy by MRS is to lower the level of N-acetylaspartate (NAA), the ratio of NAA to creatinine + choline  (NAA/(Cr + Cho) in the brain region where there is neuronal death  or damage, as well as a change in the level of myo-inositol, the  elevated level of which indicates the presence of an epileptogenic  focus, while the decreased one shows the spread of pathological activity to the adjacent tissues.Conclusion. This review will contribute to a better diagnosis of temporal lobe epilepsy, as well as to the intravital noninvasive detection of metabolic changes in the brain long before the development of structural pathology.


2018 ◽  
Vol 53 ◽  
pp. 37-45 ◽  
Author(s):  
Ying He ◽  
Tomasz Kosciolek ◽  
Jinsong Tang ◽  
Yao Zhou ◽  
Zongchang Li ◽  
...  

AbstractBackground:The microbiota-gut-brain axis and membrane dysfunction in the brain has attracted increasing attention in the field of psychiatric research. However, the possible interactive role of gut microbiota and brain function in the prodromal stage of schizophrenia has not been studied yet.Methods:To explore this, we collected fecal samples and performed Magnetic Resonance Spectroscopy (MRS) scans in 81 high risk (HR) subjects, 19 ultra-high risk (UHR) subjects and 69 health controls (HC). Then we analyzed the differences in gut microbiota and choline concentrations in the anterior cingulate cortex (ACC).Results:Presences of the orders Clostridiales, Lactobacillales and Bacteroidales were observed at increase levels in fecal samples of UHR subjects compared to the other two groups. The composition changes of gut microbiota indicate the increased production of Short Chain Fatty Acids (SCFAs), which could activate microglia and then disrupt membrane metabolism. Furthermore, this was confirmed by an increase of choline levels, a brain imaging marker of membrane dysfunction, which is also significantly elevated in UHR subjects compared to the HR and HC groups.Conclusion:Both gut microbiome and imaging studies of UHR subjects suggest the membrane dysfunction in the brain and hence might support the membrane hypothesis of schizophrenia.


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