Imaging Acute Metabolic Changes in Patients with Mild Traumatic Brain Injury Using Hyperpolarized [1-13C]Pyruvate

Edward P Hackett; Marco C Pinho; Crystal E Harrison; Galen D Reed; Jeff Liticker; Jaffar Raza; Ronald G Hall; Craig R Malloy; Surendra Barshikar; Christopher J Madden; Jae Mo Park

doi:10.1016/j.isci.2020.101885

Imaging Acute Metabolic Changes in Patients with Mild Traumatic Brain Injury Using Hyperpolarized [1-¹³C]Pyruvate

iScience. 2020 Nov 30;23(12):101885. doi: 10.1016/j.isci.2020.101885. eCollection 2020 Dec 18.

Authors

Edward P Hackett¹, Marco C Pinho^{1

2}, Crystal E Harrison¹, Galen D Reed^{1

3}, Jeff Liticker¹, Jaffar Raza⁴, Ronald G Hall⁴, Craig R Malloy^{1

5}, Surendra Barshikar⁶, Christopher J Madden⁷, Jae Mo Park^{1

2

8}

Affiliations

¹ Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
² Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
³ GE Healthcare, Dallas, TX 75390, USA.
⁴ Department of Pharmacy Practice, The Texas Tech University Health Sciences Center, Dallas, TX 75216, USA.
⁵ Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
⁶ Department of Physical Medicine & Rehabilitation, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
⁷ Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
⁸ Department of Electrical and Computer Engineering, The University of Texas at Dallas, Richardson TX 75080, USA.

Abstract

Traumatic brain injury (TBI) involves complex secondary injury processes following the primary injury. The secondary injury is often associated with rapid metabolic shifts and impaired brain function immediately after the initial tissue damage. Magnetic resonance spectroscopic imaging (MRSI) coupled with hyperpolarization of ¹³C-labeled substrates provides a unique opportunity to map the metabolic changes in the brain after traumatic injury in real-time without invasive procedures. In this report, we investigated two patients with acute mild TBI (Glasgow coma scale 15) but no anatomical brain injury or hemorrhage. Patients were imaged with hyperpolarized [1-¹³C]pyruvate MRSI 1 or 6 days after head trauma. Both patients showed significantly reduced bicarbonate (HCO₃ ^-) production, and one showed hyperintense lactate production at the injured sites. This study reports the feasibility of imaging altered metabolism using hyperpolarized pyruvate in patients with TBI, demonstrating the translatability and sensitivity of the technology to cerebral metabolic changes after mild TBI.

Keywords: Biological Sciences; Clinical Neuroscience; Molecular Neuroscience; Neuroscience; Techniques in Neuroscience.

Abstract

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