Simultaneous Measurement of GABA, Glutathione, and Glutamate–Glutamine in the Thalamus using Edited MR Spectroscopy: Feasibility and Applications in Traumatic Brain Injury

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-02-16 DOI:10.1002/jmri.29299

Xiao Liang PhD, Muhammad G. Saleh PhD, Su Xu PhD, Dirk Mayer Dr. rer. nat., Steven Roys MS, Prashant Raghavan MBBS, Neeraj Badjatia MD, Rao P. Gullapalli PhD, Jiachen Zhuo PhD

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Abstract

Background

MR spectroscopy (MRS) is a noninvasive tool for evaluating biochemical alterations, such as glutamate (Glu)/gamma-aminobutyric acid (GABA) imbalance and depletion of antioxidative glutathione (GSH) after traumatic brain injury (TBI). Thalamus, a critical and vulnerable region post-TBI, is challenging for MRS acquisitions, necessitating optimization to simultaneously measure GABA/Glu and GSH.

Purpose

To assess the feasibility and optimize acquisition and processing approaches for simultaneously measuring GABA, Glx (Glu + glutamine (Gln)), and GSH in the thalamus, employing Hadamard encoding and reconstruction of MEscher–GArwood (MEGA)-edited spectroscopy (HERMES).

Study Type

Prospective.

Subjects

28 control subjects (age: 35.9 ± 15.1 years), and 17 mild TBI (mTBI) patients (age: 32.4 ± 11.3 years).

Field Strength/Sequence

3T/T1-weighted magnetization-prepared rapid gradient-echo (MP-RAGE), HERMES.

Assessment

We evaluated the impact of acquisition with spatial saturation bands and post-processing with spectral alignment on HERMES performance in the thalamus among controls. Within-subject variability was examined in five controls through repeated scans within a week. The HERMES spectra in the posterior cingulate cortex (PCC) of controls were used as a reference for assessing HERMES performance in a reliable target. Furthermore, we compared metabolite levels and fitting quality in the thalamus between mTBI patients and controls.

Statistical Tests

Unpaired t-tests and within-subject coefficient-of-variation (CV). A P-value <0.05 was deemed significant.

Results

HERMES spectra, acquired with saturation bands and processed with spectral alignment, yielded reliable metabolite measurements in the thalamus. The mean within-subject CV for GABA, Glx, and GSH levels were 18%, 10%, and 16% in the thalamus (7%, 9%, and 16% in the PCC). GABA (3.20 ± 0.60 vs 2.51 ± 0.55, P < 0.01) and Glx (8.69 ± 1.23 vs 7.72 ± 1.19, P = 0.03) levels in the thalamus were significantly higher in mTBI patients than in controls, with GSH (1.27 ± 0.35 vs 1.22 ± 0.28, P = 0.65) levels showing no significant difference.

Data Conclusion

Simultaneous measuring GABA/Glx and GSH using HERMES is feasible in the thalamus, providing valuable insight into TBI.

Level of Evidence

Technical Efficacy

Stage 2

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使用编辑磁共振光谱法同时测量丘脑中的 GABA、谷胱甘肽和谷氨酸-谷氨酰胺：创伤性脑损伤的可行性和应用。

背景：磁共振波谱（MRS）是一种非侵入性工具，用于评估生化改变，如创伤性脑损伤（TBI）后谷氨酸（Glu）/γ-氨基丁酸（GABA）失衡和抗氧化谷胱甘肽（GSH）耗竭。目的：评估同时测量丘脑中GABA、Glx（Glu + 谷氨酰胺（Gln））和GSH的可行性并优化采集和处理方法，采用哈达玛编码和重建MEscher-GArwood（MEGA）编辑光谱（HERMES）：受试者：28 名对照组受试者（年龄：35.9 ± 15.1 岁）和 17 名轻度创伤性脑损伤（mTBI）患者（年龄：32.4 ± 11.3 岁）：3T/T1加权磁化预处理快速梯度回波（MP-RAGE），HERMES：我们评估了空间饱和带采集和频谱配准后处理对丘脑对照组 HERMES 性能的影响。通过一周内的重复扫描，对五名对照组进行了受试者内变异性检查。对照组后扣带回皮层（PCC）的 HERMES 频谱被用作评估可靠目标 HERMES 性能的参考。此外，我们还比较了 mTBI 患者和对照组丘脑中的代谢物水平和拟合质量：非配对 t 检验和受试者内变异系数 (CV)。A P 值结果：用饱和波段采集的 HERMES 光谱经光谱配准处理后，可对丘脑中的代谢物进行可靠的测量。丘脑中 GABA、Glx 和 GSH 水平的受试者内平均变异系数分别为 18%、10% 和 16%（PCC 为 7%、9% 和 16%）。GABA（3.20 ± 0.60 vs 2.51 ± 0.55，P 数据结论：使用 HERMES 同时测量丘脑中的 GABA/Glx 和 GSH 是可行的，可为创伤性脑损伤提供有价值的见解。

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