phosphocreatine and Syndrome

The selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome (DS) is an important potential complication of treatment for major depression. We hypothesized that SSRI treatment discontinuation, resulting in change in clinical state, would be associated with reduced rostral anterior cingulate choline (Cho) metabolite ratios. Individuals with a DSM-III-R diagnosis of unipolar major depression who had been stabilized on paroxetine (n = 13) or fluoxetine (n = 13) were study subjects. They were monitored for change in clinical state (mood ratings, discontinuation symptoms) and underwent proton magnetic resonance spectroscopic imaging of the rostral anterior cingulate 3 days after medication substitution with active SSRI and placebo.Placebo-day Cho/Cre (choline/total creatine) metabolite ratios were decreased in four paroxetine and two fluoxetine subjects meeting DS criteria, as compared with asymptomatic subjects (Mann-Whitney z = -2.31, p =.021). Discontinuation syndrome is associated with a rostral anterior cingulate Cho/Cre metabolite ratio decrease that may reflect dynamics of rostral anterior cingulate function.

Topics: Adult; Brain Mapping; Choline; Depressive Disorder, Major; Female; Fluoxetine; Gyrus Cinguli; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Spectroscopy; Paroxetine; Phosphocreatine; Psychiatric Status Rating Scales; Selective Serotonin Reuptake Inhibitors; Substance Withdrawal Syndrome; Syndrome

Phosphorus magnetic resonance spectroscopy (31P-MRS) was used to study in vivo the energy metabolism of brain and skeletal muscle in two members of an Italian pedigree with NARP syndrome due to a point mutation at bp 8993 of mtDNA. In the youngest patient, a 13 year old girl with retinitis pigmentosa, ataxia, and psychomotor retardation, there was an alteration of brain energy metabolism shown by a decreased phosphocreatine content, increased [ADP] and decreased phosphorylation potential. The energy metabolism of her skeletal muscle was also abnormal, as shown by resting higher inorganic phosphate and lower phosphocreatine concentrations than in normal subjects. Her mother, a 41 year old woman with minimal clinical involvement, showed a milder derangement of brain energy metabolism and normal skeletal muscle. Findings with MRS showed that this point mutation of mtDNA is responsible for a derangement of energy metabolism in skeletal muscle and even more so in the brain.

Topics: Adenosine Diphosphate; Adolescent; Adult; Ataxia; Brain; Brain Chemistry; Case-Control Studies; DNA, Mitochondrial; Energy Metabolism; Female; Follow-Up Studies; Humans; Intellectual Disability; Magnetic Resonance Spectroscopy; Muscles; Pedigree; Phosphocreatine; Phosphorus Isotopes; Phosphorylation; Point Mutation; Retinitis Pigmentosa; Syndrome

Normal-appearing white matter (NAWM) in established multiple sclerosis has been shown to be abnormal using a variety of magnetic resonance (MR) techniques, including proton MR spectroscopy ((1)H-MRS), although the stage at which these changes first appear is less clear. Using a 1.5 T scanner and single-voxel (1)H-MRS [TR 3000 ms, TE 30 ms, point-resolved spectroscopy (PRESS) localization], we determined NAWM metabolite concentrations in 96 patients a mean of 19 weeks (range 12-28 weeks) after onset of a clinically isolated syndrome (CIS) suggestive of multiple sclerosis and in 44 healthy control subjects. Absolute concentrations of N-acetyl-aspartate, total creatine and phosphocreatine (Cr), choline-containing compounds, glutamate plus glutamine, and myo-inositol (Ins) were estimated automatically using the LCModel. Compared with control subjects, the concentration of Ins was elevated in CIS NAWM (mean 3.31 mM, SD 0.86 versus mean 3.82 mM, SD 1.06; P = 0.001). The increase in Ins was also seen in the patient subgroup with abnormal T2-weighted MRI (mean 3.88 mM, SD 1.10; P = 0.001) and in those who satisfied the McDonald criteria for multiple sclerosis (mean 4.04 mM, SD 1.31; P = 0.001). An increase in Cr was also observed in CIS NAWM (P = 0.023), but other metabolites did not significantly differ between the whole CIS group and control subjects. There was no significant correlation between NAWM Ins and T2 lesion load. The early increase in Ins may reflect a process of pathogenic importance in multiple sclerosis NAWM. Follow-up studies will investigate whether the increase in NAWM Ins is of prognostic importance for future relapses and disability.

Topics: Adolescent; Adult; Aspartic Acid; Biomarkers; Brain; Creatine; Female; Humans; Inositol; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Middle Aged; Multiple Sclerosis; Phosphocreatine; Prospective Studies; Syndrome

Topics: Adult; Coronary Disease; Forearm; Humans; Hydrogen-Ion Concentration; Middle Aged; Muscles; Muscular Diseases; Phosphocreatine; Syndrome

Concentrations of the high-energy phosphates, ATP and creatine phosphate, were investigated in slow-twitch (ST) and fast-twitch (FT) muscle fibres of patients with myotonia congenita (n = 6), dystrophia myotonica (n = 5), myopathia ocularis (n = 2) and hyperornithinemia with gyrate atrophy (HOGA) (n = 3) and compared with those of normal subjects (n = 4). At rest, the patients with HOGA had lower values of ATP in ST muscle fibres than the controls (P less than 0.05). They also had lower values of creatine phosphate in these fibres than the patients with dystrophia myotonica (P less than 0.03) and myotonia congenita (P less than 0.05). After 30 s bicycle ergometer exercises there was an increase in ATP in the ST muscle fibres of the patients with myotonia congenita, but in all other patient groups there was a decrease.

Topics: Adenosine Triphosphate; Adolescent; Adult; Female; Humans; Male; Middle Aged; Muscles; Myotonia Congenita; Myotonic Dystrophy; Neuromuscular Diseases; Oculomotor Muscles; Organ Specificity; Ornithine; Phosphocreatine; Physical Exertion; Syndrome

A patient with prolonged post-viral exhaustion and excessive fatigue was examined by 31P nuclear magnetic resonance. During exercise, muscles of the forearm demonstrated abnormally early intracellular acidosis for the exercise performed. This was out of proportion to the associated changes in high-energy phosphates. This may represent excessive lactic acid formation resulting from a disorder of metabolic regulation. The metabolic abnormality in this patient could not have been demonstrated by traditional diagnostic techniques.

Topics: Adenosine Diphosphate; Adult; Body Fluids; Fatigue; Humans; Hydrogen-Ion Concentration; Intracellular Fluid; Magnetic Resonance Spectroscopy; Male; Muscles; Phosphocreatine; Physical Exertion; Syndrome; Virus Diseases

Topics: Adenosine Triphosphate; Anesthesia, Intravenous; Animals; Glucosephosphates; Halothane; Lactates; Malignant Hyperthermia; Muscles; Pentobarbital; Phosphocreatine; Swine; Swine Diseases; Syndrome