Article
Acute changes in brain metabolism in the early phase following experimental subarachnoid hemorrhage (SAH)
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Published: | June 9, 2017 |
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Objective: Metabolic changes following subarachnoid hemorrhage (SAH) with accumulation of metabolic products such as lactate, pyruvate and glutamate are described, the exact metabolic derangement and pathophysiology behind still not well understood. Especially information on metabolic changes in the early hours following SAH is rare, possibly explaining an onset of secondary brain damage during course of disease. This study was conducted to further investigate acute metabolic changes in the early phase following experimental SAH studied for the first time with in vivo injection of 13C-labeled glucose and acetate combined with ex vivo 13C magnetic resonance spectroscopy (MRS).
Methods: 18 male Sprague Dawley rats (250g-300g) were randomly assigned to one of two groups: 1) SAH induced by the endovascular filament model or 2) sham operated control animals. All animals received in vivo injection of 13C-labeled glucose and acetate before they were euthanized after 3 hours following SAH or sham operation. Ex vivo 13C MRS and HPLC of brain extracts were performed to study acute metabolic changes
Results: Three hours after experimental SAH, glycolysis was reduced in SAH hemispheres and mitochondrial metabolism in neurons was significantly impaired compared to sham operated rats. In detail, GABAergic neurons were not as much affected as Glutamatergic neurons and astrocyte metabolism seems to be more preserved.
Conclusion: For the first time, we could show significant metabolic changes in rat brains already 3 hours after SAH measured by 13C labelled MRS, giving more insight into the pathophysiology and detail of metabolic changes. Therefore, there is a potential treatment option already in the acute phase when the patient is entering the clinic, trying to prevent from secondary brain damage. Further studies will have to investigate the beneficial neuroprotective effect of possible therapeutic drugs.