In Vivo Magnetic Resonance Spectroscopy (MRS) of the Activated Human Brain at 7T

The principal aim of this thesis was to investigate human brain energy metabolism during physiological activation using proton (1H) magnetic resonance spectroscopy (MRS) at 7 Tesla (T). High magnetic fields (≥ 7 T) provide several advantages in human brain imaging and spectroscopy. In particular, signal-to-noise ratio (SNR) and chemical shift dispersion increase at higher magnetic fields, allowing for improved accuracy and precision of metabolite quantification. To take profit of the benefits of MRS at high field, one needs to provide an advanced methodology including hardware, pulse sequences experimental setup and data analysis. Each of these aspects was thoroughly explored in this thesis. In the field of functional studies, functional MRS (fMRS) has recently been used as a research tool to investigate the neuroenergetic and metabolic basis of physiologic brain activation. It provides direct insight into brain metabolism by non-invasively determining concentrations of metabolites. This is critical for the basic understanding of overall brain function, and potentially of the pathogenesis of many neurodegenerative diseases. In general, an optimized MR system and accurate acquisition methodology are required for high sensitivity and reliable metabolite quantification. The metabolites of interest for fMRS studies (e.g. lactate, glucose) are present in low concentration and metabolite changes are small under activation. Hence, studies of metabolite changes, in particular lactate, have led to inconsistent reports in the literature over the last decades. To address these challenges, it was essential to develop a robust MR protocol for the quantitative measurement of metabolite changes. A fMRS study was performed to investigate metabolite changes during visual stimulation using the enhanced sensitivity of the SPin ECho full Intensity Acquired Localized (SPECIAL) sequence. Small but significant increases of lactate (19 ± 4 %, P < 0.05) and glutamate (4 ± 1 %, P < 0.001) were observed using a small number of subjects (n = 6). With the exception of glucose (12 ± 5 %, P < 0.001), no other significant metabolite concentration changes beyond experimental error were observed. Based on this successful fMRS study, we further investigated brain energy metabolism. A subsequent fMRS study was performed to determine metabolite changes occurring during motor activation in the human brain. This second study demonstrated that increases in lactate (17 ± 5 %, P < 0.001) and glutamate (2 ± 1 %, P < 0.005) during motor stimulation were small, but similar to those observed during visual stimulation. These metabolite changes were further analyzed, and they supported the hypothesis of an increase in the change of cerebral metabolic rate of oxygen, ∆CMRO2, that is transiently lower than that of glucose, ∆CMRGlc, during the first one to two minutes of stimulation. Finally, we hypothesized that the observed glutamate and lactate increases were a general manifestation of the blood-oxygenation level dependent effect. The accuracy and the reliability of metabolite quantification is particularly challenging at short echo times due to the presence of broad underlying resonances overlapping with those of metabolite. Such resonances arise from macromolecules, which are characterized by short T1 and T2 relaxation times. Two studies were performed at 3 T and 7 T to investigate the characteristics of the macromolecule signal. An important finding was that the mathematical approximation (spline baseline) was a sufficient estimation of the macromolecule contribution to 1H spectra at 3 T compared to the experimentally measured macromolecule signal for healthy subjects. As a caveat, small, but significant, differences in the quantification may need to be taken into account when comparing metabolite concentrations obtained with these two different approaches, such as for glutamate and for γ-amino-butyric, which were more reliably quantified when using the measured macromolecule baseline. In addition, a study on the tissue-specificity of the macromolecule signal in the healthy human occipital lobe at 7 T reported that a general average macromolecule signal ensured reliable metabolite quantification. In general, these studies helped to set up a robust and reliable methodology in order to investigate human brain metabolism with improved accuracy. Despite their great potential for MRS, high main magnetic fields also compose challenges. In particular, the wavelength of the proton spin resonance becomes comparable to the size of a human head (at 7 T, λ = 11 cm). The phase variation across the brain produces signal addition (constructive interference, central bright spot) and signal cancellation (destructive interference, signal drop). Transceive arrays have been developed to address this issue. In this study, we designed, tested, and built an eight-channel transceive array, which was used to acquire images of the human head at 7 T (297 MHz). The design aimed for a low mutual coupling between the microstrip elements (> -15 dB), a relatively large penetration depth in the loading sample, reduced radiation losses and load-invariant tuning and matching. Electromagnetic simulations were run using Microwave Studio (CST, Darmstadt, Germany) for design optimization. The model was further demonstrated with the construction of the transceive array. Finally, the resulting array coil was shown to be handling, stable and also suited for techniques in which the transmission signals from all channels with different amplitudes and phases are combined. To conclude, this thesis provided complementary and new metabolic information about cerebral energy metabolism during physiological activation. Furthermore, the macromolecule studies and the building of the transceive array allowed to improve the accuracy and sensitivity of NMR measurements.

Development and implementation of ¹H magnetic resonance techniques for an improved in vivo assessment of models of cerebral metabolic disorders

Mélanie Craveiro

Nuclear magnetic resonance (NMR) is a physical phenomenon that is widely used in the biomedical field due to its non-invasive and non-destructive properties, which make it an optimal tool for the in vivo investigation of living organs such as the brain. This thesis focused on the development of 1H magnetic resonance (MR) techniques at ultra-high magnetic field strength to improve the measurement and quantification of the 1H MR signal in the rodent brain, and to accurately assess the alterations of the metabolite and water concentrations in several cerebral metabolic disorders. In rodents, 1H MR spectroscopy (MRS) allows the assessment of the concentration of up to 20 metabolites that take part in many cerebral metabolic processes such as neurotransmission, cell energy metabolism, cell growth and osmosis. 1H MRS thus provides a unique tool to non-invasively investigate the cerebral metabolism in healthy and pathological conditions in vivo. However, it is essential for reliable quantification that systematic errors and overlap of the measured metabolite signals are minimized. To that aim, the impact of a potential additional short T2 relaxation time component, which might affect the glutamine quantification at long echo times, was assessed in this thesis. The J-difference editing technique MEGA-SPECIAL was optimized to obtain the unequivocal detection of the glutamine signal at moderate echo time. As a control, the glutamine concentration obtained with this method was then compared to short echo time 1H MR spectroscopy measurements. Since the two measurements of the glutamine concentration at short and moderate echo time did not result in significant differences, this study concluded that there is a low probability of an effect of a short T2 relaxation time component on the glutamine concentration measurement. Since a reliable quantification of 1H spectra partly relies on the accurate assessment of the overlapping macromolecule contribution to the metabolites, an optimized method for the post-processing of the measured macromolecule signal was developed to ensure an accurate assessment of its contribution. This method was applied to investigate potential regional differences in the mouse brain macromolecule signals that may affect metabolite quantification when not taken into account, as well as for the assessment of macromolecule alterations in a human-glioma mouse model. No regional macro- molecule variation was found to significantly affect the metabolite quantification in the healthy mouse brain, which supports the common use of a general macromolecule spec- trum for healthy rodent brain 1H spectra quantification. However, several alterations of the macromolecule spectrum, some of which were reported for the first time, were observed in glioma tissues, and their accurate assessment was shown to be necessary for reliable metabolite quantification. Localized 1H MR spectroscopy techniques that are designed to acquire the1H MR signal from a 3D volume can also be combined with MR imaging (MRI) to acquire information on the spatial distribution of the individual metabolites, which is often of interest when heterogeneous tissues are investigated (such as in pathological conditions). This MR spectroscopic imaging (MRSI) technique is however limited in its conventional implementation by the long measurement time that is necessary to acquire the spatial information. A fast MRSI technique, spectroscopic RARE (spRARE), was therefore implemented at high magnetic field strength in this thesis in order to benefit from the advantage of high magnetic fields in addition to the rapid spatial encoding scheme offered by spRARE. Several optimizations of the metabolite signal detection were implemented in spRARE, before the efficiency of the technique was validated at 9.4 T through a comparison of the acquired in vitro metabolite signals with numerical simulations using the density matrix formalism. The in vivo quantification of the water content is also of interest as it offers perspec- tives for investigating cerebral disease progression that is associated with brain water content alterations. In addition, when the water signal is used as an internal reference for metabolite concentration quantification in MRS, such knowledge can also contribute to a more reliable quantification. A method that is based on the multi-spin-echo MRI technique was therefore developed for the absolute quantification of the water content in the rodent brain, with the aim of assessing alterations of its content in pathological conditions. It was then applied on a bile-duct-ligation rat model of chronic hepatic encephalopathy (HE) to assess the brain water content changes associated with the disease as well as its metabolic alterations. The absence of significant brain water content changes detected in the investigated HE rat model, which was supported by post-mortem brain water content measurements using gravimetry and the dry/wet weight-ratio technique, potentially opens the way for investigating cerebral metabolic processes in chronic HE in absence of edema formation. Localized 1H MRS and conventional MRSI were also applied for the investigation of rodent models of brain disorders in order to assess the metabolic profile associated with those disorders. These studies for the first time allowed the assessment of GABA as a potential early Parkinson’s disease marker, while they also provided new insights into the role of the PPAR-β brain receptor in the early neuroprotective effects following ischemia.

EPFL2013

Proton and phosphorus magnetic resonance spectroscopy of a mouse model of Alzheimer's disease

Patrick Aebischer, Cristina Ramona Cudalbu, Rolf Gruetter, Sharon Janssens, Hongxia Lei, Bernard Schneider, Lili Sun-Reimer

The development of new diagnostic criteria for Alzheimer's disease (AD) requires new in vivo markers reflecting early pathological changes in the brain of patients. Magnetic resonance (MR) spectroscopy has been shown to provide useful information about the biochemical changes occurring in AD brain in vivo. The development of numerous transgenic mouse models of AD has facilitated the evaluation of early biomarkers, allowing researchers to perform longitudinal studies starting before the onset of the pathology. In addition, the recent development of high-field animal scanners enables the measurement of brain metabolites that cannot be reliably quantified at lower magnetic fields. In this report, we studied a new transgenic mouse model of AD, the 5xFAD model, by in vivo proton and phosphorus MR spectroscopy. This model, which is characterized by an early-onset and a robust amyloid pathology, developed changes in the neurochemical profile, which are typical in the human disease, i.e., an increase in myo-inositol and a decrease in N-acetylaspartate concentrations, as early as in the 40th week of age. In addition, a significant decrease in the γ-aminobutyrate concentration was observed in transgenic mice at this age compared to controls. The pseudo-first-order rate constant of the creatine kinase reaction as well as relative concentrations of phosphorus-containing metabolites were not changed significantly in the 36 and 72-week old transgenic mice. Overall, these results suggest that mitochondrial activity in the 5 × FAD mice is not substantially affected but that the model is relevant for studying early biomarkers of AD.

Ios Press2012

Proton diffusion spectroscopy and modeling of brain metabolism at 14.1T

Masoumeh Dehghani Moghadam

As a field at the CIBM, Nuclear magnetic resonance (NMR)spectroscopy can be applied non-invasively to explore the metabolic fate of energy fuel substrates, as well as the rate at which they are consumed, using 13C and 1H nuclei. The work of this thesis encompasses both nuclei, and focuses on (1) improving the quantification and modeling of glucose-derived metabolites; and (2) characterizing diffusion-related parameters of the purportedly glial-specific energy substrate, acetate. Both aim to quantitatively explore cerebral energy metabolism, at ultra-high magnetic field, in vivo, in the healthy rat. 13C NMR spectroscopy, as a tool, enables measuring the progressive incorporation of 13C-glucose into brain glucose and then NMR detectable amino acids (glutamate and glutamine); this relies on the infusion of the 13C-labeled energy substrate. The experimentally obtained 13C labelling curves are analyzed using suitable mathematical models to provide an estimation of cerebral metabolic rates. Here, a dynamic model of time-courses of 13C multiplets arising from isotopomers was considered. So beyond the two-compartment neuronal-glial model, we took into account additional data on the dynamics of 13C isotopomers, available from the fine structure multiplets in 13C spectra of glutamate and glutamine, measured under prolonged [1-6,13C] glucose infusion. We concluded that the dynamic analyses of 13C multiplet time courses of glutamate and glutamine resulted in a higher precision for estimating the absolute values of most cerebral metabolic rates. Acetate metabolism is challenging because dynamic metabolic modeling requires prior knowledge of the transport and uptake kinetics of infused acetate. We sought this information by determining the apparent concentration and distribution volume (V_d) of cerebral acetate between the intracellular and the extracellular compartments. Experimentally, the diffusion characteristics of cerebral acetate were measured, relative to that of N-Acetylaspartate (NAA, known to be mainly intracellular) using diffusion-weighted 1H NMR spectroscopy at 14.1T, under prolonged acetate infusion. The detection of an acetate and NAA signal at large diffusion weighting provided direct experimental evidence of intracellular cerebral acetate and NAA, although a substantial fraction of acetate was extracellular. To estimate the apparent concentration of in vivo brain acetate, T1 and T2 relaxation times of acetate were measured. The longer T1 relaxation and shorter T2 relaxation times of acetate compared with NAA provided evidence of its small molecular size, and possibly different chemical environment. Our experimentally determined value of V_dled to cerebral metabolic rates of acetate (CMR acetate) of the same order reported for the glial Krebâs cycle rate, an indication that estimates of CMR acetate are highly dependent on V_d. Finally, in order to pursue metabolic mapping of cerebral acetate uptake in the rat, in vivo, at 14.1 T, the design and construction of a combined transmit-birdcage coil and receive-quadrature pair surface coil was considered. Its performance was compared to a single birdcage coil in the transmit/receive mode. So far, the preliminary results of the 2-coil configuration are promising: homogenous excitation and a gain in sensitivity up to a distance of 5 mm are achievable. Improvements are ongoing for NMR spectroscopic and imaging applications at 14.1 T.