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DOI: 10.1055/s-2002-28273
Quantitative analysis of energy metabolism in human muscle using SLOOP 31P-MR-spectroscopy
Quantitative Erfassung des muskulären Energiestoffwechsels mittelsSLOOP 31P-MR-Spektroskopie am Menschen
Publication History
12. 2. 2002
after revision 15. 3. 2002
Publication Date:
07 May 2002 (online)
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Abstract
Objective: Energy metabolism is vital for regular muscle function. In humans, in-vivo analysis using 31P-MR-spectroscopy (MRS) is mostly restricted to semiquantitative parameters due to technical demands. We applied Spatial Localization with Optimal Pointspread Function (SLOOP) for quantification in human skeletal and cardiac muscle. Subjects/Methods: 10 healthy volunteers and 4 patients with myotonic dystrophy type 1 were examined using a 1.5 T system (Magnetom VISION) and chemical shift imaging (CSI) for data collection. Concentrations of PCr, ATP and Pi as well as PCr/ATP ratios were calculated by SLOOP. Results: Concentrations of PCr, ATP and Pi were 29.9 ± 3.4, 7.1 ± 0.9 and 5.7 ± 1.2 [mmol/kg] in normal skeletal muscle, corresponding to previously published studies. Two of the patients with a duration of disease longer than 10 years and a pronounced muscle weakness showed a significant decrease of PCr and ATP in skeletal muscle below 10 and 5 mmol/kg. One of these patients had an additional reduction of PCr in cardiac muscle. Conclusions: With MRS and SLOOP, a more accurate quantitative assessment of metabolism is now available in skeletal and cardiac muscle. Longitudinal studies of larger patient groups will allow to better describe the metabolic disorder in muscle disease over time. Moreover, these techniques offer a new way to quantify treatment effects in future trials.
Zusammenfassung
Ziel: Voraussetzung für eine reguläre Muskelfunktion ist ein intakter Energiestoffwechsel. Beim Menschen beschränkten sich bisherige Untersuchungen mittels der 31P-MR-Spektroskopie (MRS), welche eine In-Vivo-Analyse erlaubt, jedoch zumeist auf die Analyse semiquantitativer Parameter. Wir verwendeten Spatial Localization with Optimal Pointspread Function (SLOOP), um den Stoffwechsel des Skelettmuskels wie des Herzens zu quantifizieren. Patienten/Methoden: 10 Probanden und 4 Patienten mit myotoner Dystrophie Typ 1 wurden an einem 1.5-T-System (Magnetom VISION) mittels der chemical shift imaging (CSI)-Technik untersucht. Die Berechnung der Konzentrationen von PCr, ATP und Pi sowie des PCr/ATP Verhältnisses erfolgte mittels SLOOP. Ergebnisse: Im Skelettmuskel gesunder Probanden betrugen die Absolutkonzentrationen für PCr, ATP und Pi 29,9 ± 3.4, 7,1 ± 0,9 und 5,7 ± 1,2 [mmol/kg] in Übereinstimmung mit früheren Studien. Bei zwei Patienten mit einer Krankheitsdauer über 10 Jahre sowie einer ausgeprägten Muskelschwäche wurde eine signifikante Abnahme von PCr und ATP unter 10 bzw. 5 mmol/kg im Skelettmuskel beobachtet. Einer dieser Patienten zeigte zusätzlich eine Reduzierung der PCr Konzentration im Herzmuskel. Schlussfolgerung: Mittels SLOOP ist eine kombinierte quantitative Erfassung des Stoffwechsels im menschlichen Skelett- und Herzmuskel möglich. Verlaufsuntersuchungen größerer Patientenkollektive sind jetzt möglich. Ferner verspricht die Methode eine bessere Beurteilung der Wirkung neuer Therapien in zukünftigen klinischen Studien.
Key words
MR spectroscopy - Bioenergetics - Human skeletal muscle - Myotonic dystrophy - Cardiac involvement
Schlüsselwörter
MR-Spektroskopie - Metabolismus - Menschlicher Skelettmuskel - Myotone Dystrophie - Herzbeteiligung
References
- 1 Barnes P R, Kemp G J, Taylor D J, Radda G K. Skeletal muscle metabolism in myotonic dystrophy. A 31P magnetic resonance spectroscopy study. Brain. 1997; 120 (Pt 10)) 1699-1711
- 2 Beer M, Landschütz W, Meininger M, Seyfarth T, Viehrig M, Sandstede J, Pabst T, Kenn W, Horn M, Harre K, von Kienlin M, Neubauer S, Hahn D. Determination of absolute concentrations of cardiac high-energy phosphates using 31P-MR-spectroscopy and SLOOP in healthy and diseased myocardium. Fortschr Röntgenstr.. 1999; 171 65-68
- 3 Beer M, Sandstede J, Weilbach F, Spindler M, Köstler H, Pabst T, Kenn W, Toyka K V, Ertl G, Hahn D. Cardiac metabolism and function in patients with multiple sclerosis: a combined 31P-MR-Spectroscopy and MRI study. Fortschr Röntgenstr. 2001; 173 (5) 399-404
- 4 Doyle V L, Payne G S, Collins D J, Verrill M W, Leach M O. Quantification of phosphorus metabolites in human calf muscle and soft-tissue tumours from localized MR spectra acquired using surface coils. Phys Med Biol. 1997; 42 (4) 691-706
- 5 Lodi R, Kemp G J, Muntoni F, Thompson C H, Rae C, Taylor J, Styles P, Taylor D J. Reduced cytosolic acidification during exercise suggests defective glycolytic activity in skeletal muscle of patients with Becker muscular dystrophy. An in vivo 31P magnetic resonance spectroscopy study. Brain. 1999; 122 (Pt 1) 121-130
- 6 Roussel M, Bendahan D, Mattei J P, Le Fur Y, Cozzone P J. 31P magnetic resonance spectroscopy study of phosphocreatine recovery kinetics in skeletal muscle: the issue of intersubject variability. Biochem Biophys Acta. 2000; 1457 (1 - 2) 18-26
- 7 Tarnopolsky M A, Parise G. Direct measurement of high-energy phosphate compounds in patients with neuromuscular disease. Muscle Nerve. 1999; 22 (9) 1228-1233
- 8 Harris R C, Hultman E, Nordesjö L O. Glycogen, glycolytic intermediates and high-energy phosphates determined in biopsy samples of musculus quadriceps femoris of man at rest. Methods and variance of values. Scand J Clin Lab Invest. 1974; 33 109-120
- 9 Buchli R, Meier D, Martin E, Boesiger P. Assessment of absolute metabolite concentrations in human tissue by 31P-MRS in vivo. Part II: muscle, liver, kidney. Magn Reson Med. 1994; 32 453-458
- 10 Ambroggi L D, Raisaro A, Marchiano V, Radice S, Meola G. Cardiac involvement in patients with myotonic dystrophy: charcteristic features of magnetic resonance imaging. Eur Heart J. 1995; 16 1007-1010
- 11 Perloff J K, Stevenson W G, Roberts N K, Cabeen W, Weiss J. Cardiac involvement in myotonic muscular dystrophy (Steinert's disease): a prospective study of 25 patients. Am J Cardiol. 1984; 54 1074-1081
- 12 Stöllberger C, Finsterer J, Keller H, Mamoli B, Slany J. Progression of cardiac involvement in patients with myotonic dystrophy, Becker's Muscular Dystrophy and Mitochondrial Myopathy during a 2-year follow-up. Cardiology. 1998; 90 173-179
- 13 Perloff J K, Henze E, Schelbert H R. Alterations in regional myocardial metabolism, perfusion and wall motion in Duchenne muscular dystrophy studied by radionuclide imaging. Circulation. 1984; 69 33-42
- 14 Brook J D, McCurrach M E, Harley H G. Molecular basis of myotonic dystrophy: expansion of a trinucleotide (CTG) repeat at the 3' end of the transcript encoding a protein kinase family. Cell. 1992; 68 799-808
- 15 Brown T R, Stoyanova R, Greenberg T, Srinivasan R, Murphy-Boesch J. NOE enhancements and T1 relaxation times of phosphorylated metabolites in human calf muscle at 1.5 Tesla. Magn Reson Med. 1995; 33 (3) 417-421
- 16 Bergström J, Guarnieri G, Hultman E. Carbohydrate metabolism and electrolyte changes in human muscle tissue during heavy work. J appl Physiol. 1971; 30 122
- 17 Persky A M, Brazeau G A. Clinical pharmacology of the dietary supplement creatine monohydrate. Pharmacol Rev. 2001; 53 161-176
Dr. med. Meinrad Beer
Institut für Röntgendiagnostik, Medizinische Poliklinik, Universität Würzburg
Klinikstraße 8
97070 Würzburg
Phone: +49 931 201 70300
Fax: +49 931 201 70100
Email: meinrad.beer@mail.uni-wuerzburg.de