EARLY TIME COURSE OF N-ACETYLASPARTATE, CREATINE AND PHOSPHOCREATINE, AND COMPOUNDS CONTAINING CHOLINE IN THE BRAIN AFTER ACUTE STROKE - A PROTON MAGNETIC-RESONANCE SPECTROSCOPY STUDY
EARLY TIME COURSE OF N-ACETYLASPARTATE, CREATINE AND PHOSPHOCREATINE, AND COMPOUNDS CONTAINING CHOLINE IN THE BRAIN AFTER ACUTE STROKE - A PROTON MAGNETIC-RESONANCE SPECTROSCOPY STUDY
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DOI：
10.1161/01.str.23.11.1566
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发表时间：
1992-11-01
期刊：
影响因子：
8.3
通讯作者：
ARLIENSOBORG, P
中科院分区：
文献类型：
--
作者：
GIDEON, P;HENRIKSEN, O;ARLIENSOBORG, P
背景和目的：通过局部水抑制质子磁共振波谱在体内研究急性脑卒中后的早期N-乙酰天冬氨酸、肌酸和磷酸肌酸以及含有胆碱的化合物的变化。方法：对8名急性脑卒中患者的急性期、临床症状出现后1周和临床症状出现后2-4周进行连续研究。十名健康志愿者作为对照。刺激回波 (STEAM) 序列用于测量位于梗塞区域内的感兴趣体积中的脑代谢物，如磁共振成像所显示的那样。为了定量，使用不饱和水信号作为内标。采用单光子发射计算机断层扫描，使用 Tc-99m 标记的 d,l-六亚甲基丙烯胺肟作为血流示踪剂，测量梗死区相对于对称未受影响区域的局部脑血流量。 结果：急性期梗塞区的相对局部脑血流量显着减少。 1周后，除一名患者外，所有患者均出现充血。 N-乙酰天冬氨酸含量显着降低，损失似乎发生在中风事件后 6 至 24 小时之间。 N-乙酰天冬氨酸含量的减少在梗塞区域的中心部分比周围部分更大。梗塞区域的肌酸和磷酸肌酸也减少，而胆碱含量没有显着变化。结论：假设N-乙酰天冬氨酸含量反映神经元的存活或损失，我们的结果可能表明，应在中风发作后的前6小时内开始恢复严重缺血区域血流的治疗程序。
Background and Purpose: The early time course after acute stroke of cerebral N-acetylaspartate, creatine and phosphocreatine, and compounds containing choline was studied in vivo by means of localized water-suppressed proton magnetic resonance spectroscopy.Methods: Eight patients with acute stroke were studied serially in the acute phase, 1 week after, and 2-4 weeks after the onset of clinical symptoms. Ten healthy volunteers served as controls. A stimulated echo (STEAM) sequence was used for measurement of the brain metabolites in a volume of interest located within the infarcted area as visualized by magnetic resonance imaging. For quantification, the unsaturated water signal was used as the internal standard. Regional cerebral blood flow in the infarcted area was measured relative to a symmetrically located unaffected area by means of single-photon emission computed tomographic scanning, using Tc-99m-labeled d,l-hexamethylenepropyleneamine oxime as the flow tracer.Results: Relative regional cerebral blood How was considerably reduced in the infarcted area in the acute phase. After 1 week, hyperemia was seen in all but one patient. The N-acetylaspartate content was significantly reduced, with the loss appearing to occur between 6 and 24 hours after the stroke incident. The reduction in N-acetylaspartate content was greater in the central part than in the peripheral part of the infarcted area. Creatine and phosphocreatine were also reduced in the infarcted area, whereas no significant change was seen in the choline content.Conclusions: Assuming that N-acetylaspartate content reflects neuronal survival or loss, our results may suggest that treatment procedures with restoration of blood flow to severely ischemic areas should be initiated within the first 6 hours after stroke onset.