Two Pools of ATP Detected in the Brains of Pediatric Patients with Myelin Oligodendrocyte Glycoprotein Antibody Disorders (MOGAD) by 3D 31P MR Spectroscopic Imaging (MRSI) at 7T

Over the past four decades, ATP, the obligatory energy molecule for keeping all cells alive and functioning, was thought to contribute only one set of 31P MR signals in the human brain. Here we report for the first time the simultaneous detection of two pools of ATP in the human brain by high-resolution 3D 31P MRSI at ultrahigh field 7T. These two ATP pools differ in cytosolic Mg2+ concentration (1:0.5 ratio), with a resonance separation of 0.5 ppm at beta-ATP, a well-established imaging marker of intracellular Mg2+ concentration. Mg2+ is a cofactor of ATPase and its deficiency is associated with immune dysfunction, free radical damage, perturbations in Ca2+ homeostasis, development of atherosclerosis and dyslipidemia, and a number of neurological disorders, such as cerebral vasospasm, stroke, migraine, Alzheimer's disease, and Parkinson's disease. Our study documents reduced Mg levels in the brain of patients with myelin oligodendrocyte glycoprotein antibody disorders (MOGAD), which is an idiopathic, inflammatory, demyelinating condition of the central nervous system (CNS) more common in pediatric patients. Low-Mg2+ ATP signals in MOGAD were detected mostly in the white matter regions, which may suggest Mg2+ deficiency in oligodendrocytes, which are primarily responsible for maintenance and generation of the axonal myelin sheath. This preliminary study demonstrates the utility of the 7T 3D 31P MSRI for revealing altered energy metabolism with reduced Mg availability at a normal ATP level. The potential correlation between [Mg2+] and disease progression over time should be assessed in larger cohorts.

2½-minute 3D 7T 31P-MRSI of the human heart using concentric rings (CRT)

A 3D density-weighted concentric ring trajectory (CRT) MRSI sequence is implemented for cardiac 31P-MRS at 7T. The point-by-point k-space sampling of traditional phase-encoded CSI sequences severely restricts the minimum scan time at higher spatial resolutions. Our proposed CRT sequence implements a stack of concentric rings trajectory, with a variable number of rings and planes spaced to optimise the density of k-space weighting. This creates flexibility in acquisition time, allowing acquisitions substantially faster than traditional phase-encoded CSI sequences, while retaining high SNR. We first characterise the signal-to-noise ratio and point spread function of the CRT sequence in phantoms. We then evaluate it at five different acquisition times and spatial resolutions in the hearts of five healthy participants at 7T. These different sequence durations are compared with existing published 3D acquisition-weighted CSI sequences with matched acquisition times and spatial resolutions. To minimise the effect of noise on the short acquisitions, low-rank denoising of the spatio-temporal data was also performed after acquisition. The proposed sequence measures 3D localised PCr/ATP ratios of the human myocardium in 2.5 minutes, 2.6 times faster than the minimum scan time for the acquisition-weighted phase-encoded CSI. Alternatively, in the same scan time a 1.7-times smaller nominal voxel volume can be achieved. Low-rank denoising reduced the variance of measured PCr/ATP ratios by 11% across all protocols. The faster acquisitions permitted by 7T CRT 31P-MRSI could make cardiac stress protocols or creatine kinase rate measurements (which involve repeated scans) more tolerable for patients without sacrificing spatial resolution.

Hippocampal Glutathione Depletion and pH Increment in Alzheimer’s Disease: An in vivo MRS Study

Background: Oxidative stress plays a major role in Alzheimer’s disease (AD) pathogenesis, and thus, antioxidant glutathione (GSH) has been actively investigated in mitigating the oxidative load. Significant hippocampal GSH depletion has been correlated with cognitive impairment in AD. Furthermore, postmortem studies indicated alterations in cellular-energy metabolism and hippocampal pH change toward alkalinity in AD. Objective: Concurrent analysis of hippocampal GSH and pH interplay in vivo on the same individual is quite unclear and hence requires investigation to understand the pathological events in AD. Methods: Total 39 healthy old (HO), 22 mild cognitive impairment (MCI), and 37 AD patients were recruited for hippocampal GSH using 1H-MRS MEGA-PRESS and pH using 2D 31P-MRSI with dual tuned (1H/31P) transmit/receive volume head coil on 3T-Philips scanner. All MRS data processing using KALPANA package and statistical analysis were performed MedCalc, respectively and NINS-STAT package. Results: Significant GSH depletion in the left and right hippocampus (LH and RH) among MCI and AD study groups as compared to HO was observed, whereas pH increased significantly in the LH region between HO and AD. Hippocampal GSH level negatively correlated with pH in both patient groups. The ROC analysis on the combined effect of GSH and pH in both hippocampal regions give accuracy for MCI (LH: 78.27%; RH: 86.96%) and AD (LH: 88%; RH: 78.26%) groups differentiating from HO. Conclusion: Outcomes from this study provide further insights to metabolic alterations in terms of concurrent assessment of hippocampal GSH and pH levels in AD pathogenesis, aiding in early diagnosis of MCI and AD.