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Case Report

Imaging Neurodegenerative Metabolism in Amyotrophic Lateral Sclerosis with Hyperpolarized [1-13C]pyruvate MRI

1
The MR Research Center, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
2
Department of Clinical Neurophysiology, Aarhus University Hospital, 8200 Aarhus, Denmark
3
Center of Functionally Integrative Neuroscience, Aarhus University, 8200 Aarhus, Denmark
4
Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
*
Author to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2022, 8(3), 1570-1577; https://doi.org/10.3390/tomography8030129
Received: 30 April 2022 / Revised: 8 June 2022 / Accepted: 11 June 2022 / Published: 14 June 2022
(This article belongs to the Section Brain Imaging)
The cause of amyotrophic lateral sclerosis (ALS) is still unknown, and consequently, early diagnosis of the disease can be difficult and effective treatment is lacking. The pathology of ALS seems to involve specific disturbances in carbohydrate metabolism, which may be diagnostic and therapeutic targets. Magnetic resonance imaging (MRI) with hyperpolarized [1-13C]pyruvate is emerging as a technology for the evaluation of pathway-specific changes in the brain’s metabolism. By imaging pyruvate and the lactate and bicarbonate it is metabolized into, the technology is sensitive to the metabolic changes of inflammation and mitochondrial dysfunction. In this study, we performed hyperpolarized MRI of a patient with newly diagnosed ALS. We found a lateralized difference in [1-13C]pyruvate-to-[1-13C]lactate exchange with no changes in exchange from [1-13C]pyruvate to 13C-bicarbonate. The 40% increase in [1-13C]pyruvate-to-[1-13C]lactate exchange corresponded with the patient’s symptoms and presentation with upper-motor neuron affection and cortical hyperexcitability. The data presented here demonstrate the feasibility of performing hyperpolarized MRI in ALS. They indicate potential in pathway-specific imaging of dysfunctional carbohydrate metabolism in ALS, an enigmatic neurodegenerative disease. View Full-Text
Keywords: metabolic; magnetic resonance imaging; hyperpolarized; pyruvate; amyotrophic lateral sclerosis; neurodegeneration metabolic; magnetic resonance imaging; hyperpolarized; pyruvate; amyotrophic lateral sclerosis; neurodegeneration
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MDPI and ACS Style

Bøgh, N.; Laustsen, C.; Hansen, E.S.S.; Tankisi, H.; Bertelsen, L.B.; Blicher, J.U. Imaging Neurodegenerative Metabolism in Amyotrophic Lateral Sclerosis with Hyperpolarized [1-13C]pyruvate MRI. Tomography 2022, 8, 1570-1577. https://doi.org/10.3390/tomography8030129

AMA Style

Bøgh N, Laustsen C, Hansen ESS, Tankisi H, Bertelsen LB, Blicher JU. Imaging Neurodegenerative Metabolism in Amyotrophic Lateral Sclerosis with Hyperpolarized [1-13C]pyruvate MRI. Tomography. 2022; 8(3):1570-1577. https://doi.org/10.3390/tomography8030129

Chicago/Turabian Style

Bøgh, Nikolaj, Christoffer Laustsen, Esben S.S. Hansen, Hatice Tankisi, Lotte B. Bertelsen, and Jakob U. Blicher. 2022. "Imaging Neurodegenerative Metabolism in Amyotrophic Lateral Sclerosis with Hyperpolarized [1-13C]pyruvate MRI" Tomography 8, no. 3: 1570-1577. https://doi.org/10.3390/tomography8030129

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