Brain metabolites in autonomic regulatory insular sites in heart failure

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:346

Article

Woo, Mary A.¹  Yadav, Santosh K.²  Macey, Paul M.^1,3  Fonarow, Gregg C.⁴  Harper, Ronald M.^3,5  Kumar, Rajesh^2,3,6,7 

[1] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA

[2] Univ Calif Los Angeles, Dept Anesthesiol, Los Angeles, CA 90095 USA

[3] Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90095 USA

[4] Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA 90095 USA

[5] Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA

[6] Univ Calif Los Angeles, Dept Radiol Sci, Los Angeles, CA 90095 USA

[7] Univ Calif Los Angeles, Dept Bioengn, Los Angeles, CA 90095 USA

关键词: Magnetic resonance spectroscopy;    N-acetylaspartate;    Choline;    Myo-inositol;    Depression;    Pain;   

DOI  :  10.1016/j.jns.2014.09.006

来源: Elsevier

【 摘 要 】

Autonomic, pain, and neuropsychologic comorbidities appear in heart failure (HF), likely resulting from brain changes, indicated as loss of structural integrity and functional deficits. Among affected brain sites, the anterior insulae are prominent in serving major regulatory roles in many of the disrupted functions commonly seen in HF. Metabolite levels, including N-acetylaspartate (NAA), creatine (Cr), choline (Cho), and myo-inositol (MI), could indicate the nature of anterior insula tissue injury in HF. The study aim was to assess anterior insular metabolites to determine processes mediating autonomic, pain, and neuropsychologic disruptions in HF. We performed magnetic resonance spectroscopy in bilateral anterior insulae in 11 HF and 53 controls, using a 3.0-Tesla magnetic resonance imaging scanner. Peaks for NAA at 2.02 ppm, Cr at 3.02 ppm, Cho at 3.2 ppm, and MI at 3.56 ppm were assigned, peak areas were calculated, and metabolites were expressed as ratios, including NAA/Cr, Cho/Cr, and MI/Cr. HF patients showed significantly increased Cho/Cr ratios, indicative of glial proliferation or injury, on the left anterior insula, and reduced NAA/Cr levels, suggesting neuronal loss/dysfunction, on the right anterior insula over controls. No differences in MI/Cr ratios appeared between groups. Right anterior insular neuronal loss and left glial alterations may contribute to distorted autonomic, pain, and neuropsychologic functions found in HF. (C) 2014 Elsevier B.V. All rights reserved.

【 授权许可】

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