TY  - JOUR
A1  - Reiländer, Annemarie
A1  - Pilatus, Ulrich
A1  - Schüre, Jan-Rüdiger
A1  - Shrestha, Manoj
A1  - Deichmann, Ralf
A1  - Nöth, Ulrike
A1  - Hattingen, Elke
A1  - Gracien, René-Maxime
A1  - Wagner, Marlies
A1  - Seiler, Alexander
T1  - Impaired oxygen extraction and adaptation of intracellular energy metabolism in cerebral small vessel disease
T2  - Cerebral circulation - cognition and behavior
N2  - Highlights
• Increased  values in SVD, suggesting reduced oxygen extraction fraction (OEF).
• Vascular dysfunction and microstructural impairment limit OEF capacity.
• Association between prolonged  and more alkaline intracellular pH.
• Adaptation of intracellular energy metabolism compensates for reduced OEF.
Abstract
Background: We aimed to investigate whether combined phosphorous (31P) magnetic resonance spectroscopic imaging (MRSI) and quantitative T′2 mapping are able to detect alterations of the cerebral oxygen extraction fraction (OEF) and intracellular pH (pHi) as markers the of cellular energy metabolism in cerebral small vessel disease (SVD).
Materials and methods: 32 patients with SVD and 17 age-matched healthy control subjects were examined with 3-dimensional 31P MRSI and oxygenation-sensitive quantitative T′2 mapping (1/T′2 = 1/T2* - 1/T2) at 3 Tesla (T). PHi was measured within the white matter hyperintensities (WMH) in SVD patients. Quantitative T′2 values were averaged across the entire white matter (WM). Furthermore, T′2 values were extracted from normal-appearing WM (NAWM) and the WMH and compared between patients and controls.
Results: Quantitative T′2 values were significantly increased across the entire WM and in the NAWM in patients compared to control subjects (149.51 ± 16.94 vs. 138.19 ± 12.66 ms and 147.45 ± 18.14 vs. 137.99 ± 12.19 ms, p < 0.05). WM T′2 values correlated significantly with the WMH load (ρ=0.441, p = 0.006). Increased T′2 was significantly associated with more alkaline pHi (ρ=0.299, p < 0.05). Both T′2 and pHi were significantly positively correlated with vascular pulsatility in the distal carotid arteries (ρ=0.596, p = 0.001 and ρ=0.452, p = 0.016).
Conclusions: This exploratory study found evidence of impaired cerebral OEF in SVD, which is associated with intracellular alkalosis as an adaptive mechanism. The employed techniques provide new insights into the pathophysiology of SVD with regard to disease-related consequences on the cellular metabolic state.
KW  - Small vessel disease
KW  - Oxygen extraction fraction
KW  - Cellular energy metabolism
KW  - MR spectroscopy
KW  - quantitative MRI
KW  - Microstructural impairment
Y1  - 2023
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78802
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-788023
SN  - 2666-2450
VL  - 4
IS  - art. 100162
PB  - Elsevier
CY  - Amsterdam
ER  -