Metabolic changes after amputation using magnetic resonance spectroscopy

To study the metabolic changes following amputation, we investigated the metabolite concentrations in the secondary somatosensory cortex and thalamus from twenty-three upper limb amputees and sixteen age-matched healthy controls using proton magnetic resonance spectroscopy (MRS). The ratios of major metabolites to the creatine (Cr) peak were quantified to indicate metabolite levels. Compared with the healthy controls, the amputees showed significantly reduced NAA/Cr and Cho/Cr ratios in the secondary somatosensory cortex and thalamus contralateral to the amputation side, indicating neuronal loss and dysfunctions in these brain regions due to the loss of sensory input. Meanwhile, the stump sensation was found to be positively correlated with NAA/Cr ratio and negatively correlated with GSH/Cr ratio in the thalamus. The results suggested that both the thalamus and somatosensory cortex may undergo metabolic changes after amputation.

[1]  Anders Björkman,et al.  Phantom digit somatotopy: a functional magnetic resonance imaging study in forearm amputees , 2012, The European journal of neuroscience.

[2]  F. Panetsos,et al.  Chronic electrical stimulation of transected peripheral nerves preserves anatomy and function in the primary somatosensory cortex , 2012, The European journal of neuroscience.

[3]  P. Garnier,et al.  N‐Acetylaspartate, a marker of both cellular dysfunction and neuronal loss: its relevance to studies of acute brain injury , 2001, Journal of neurochemistry.

[4]  Magnetic Resonance Spectroscopy to Assess NeuroInflammation and Neuropathic Pain , 2013, Journal of Neuroimmune Pharmacology.

[5]  H. Flor,et al.  Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation , 2016, Scientific Reports.

[6]  L. Descarries,et al.  Decrease and long‐term recovery of choline acetyltransferase immunoreactivity in adult cat somatosensory cortex after peripheral nerve transections , 1995, The Journal of comparative neurology.

[7]  A. Chauhan,et al.  Glutathione redox imbalance in brain disorders , 2015, Current opinion in clinical nutrition and metabolic care.

[8]  M. Smeyne,et al.  Glutathione metabolism and Parkinson's disease. , 2013, Free radical biology & medicine.

[9]  A. Alkan,et al.  Magnetic resonance spectroscopy study of proton metabolite level changes in sensorimotor cortex after upper limb replantation-revascularization. , 2005, Magnetic resonance imaging.

[10]  H. Flor,et al.  Phantom limb pain: a case of maladaptive CNS plasticity? , 2006, Nature Reviews Neuroscience.

[11]  I. Wilkinson,et al.  Thalamic neuronal dysfunction and chronic sensorimotor distal symmetrical polyneuropathy in patients with type 1 diabetes mellitus , 2008, Diabetologia.

[12]  Heidi Johansen-Berg,et al.  Phantom pain is associated with preserved structure and function in the former hand area , 2013, Nature Communications.

[13]  S. Rivest,et al.  Peripheral Nerve Injury Alters Blood–Spinal Cord Barrier Functional and Molecular Integrity through a Selective Inflammatory Pathway , 2011, The Journal of Neuroscience.

[14]  D J Jenden,et al.  In vivo 1H MRS choline: correlation with in vitro chemistry/histology. , 1996, Life sciences.

[15]  Ivanei E. Bramati,et al.  Functional Expansion of Sensorimotor Representation and Structural Reorganization of Callosal Connections in Lower Limb Amputees , 2012, The Journal of Neuroscience.

[16]  Ulf Ziemann,et al.  Rapid modulation of GABA in sensorimotor cortex induced by acute deafferentation , 2002, Annals of neurology.

[17]  F. Panetsos,et al.  Substitution of natural sensory input by artificial neurostimulation of an amputated trigeminal nerve does not prevent the degeneration of basal forebrain cholinergic circuits projecting to the somatosensory cortex , 2014, Front. Cell. Neurosci..

[18]  Sumiti Saharan,et al.  The emerging role of glutathione in Alzheimer's disease. , 2014, Journal of Alzheimer's disease : JAD.

[19]  S. Provencher.  Estimation of metabolite concentrations from localized in vivo proton NMR spectra , 1993, Magnetic resonance in medicine.

[20]  Richard M. Napier,et al.  Large-Scale Sprouting of Cortical Connections After Peripheral Injury in Adult Macaque Monkeys , 1998 .

[21]  Eric L Zager,et al.  Pathophysiology of peripheral nerve injury: a brief review. , 2004, Neurosurgical focus.

[22]  T. Baysal,et al.  Early- and late-state subacute sclerosing panencephalitis: chemical shift imaging and single-voxel MR spectroscopy. , 2003, AJNR. American journal of neuroradiology.

[23]  N. Birbaumer,et al.  Painful and nonpainful phantom and stump sensations in acute traumatic amputees. , 2008, The Journal of trauma.

[24]  X. Navarro,et al.  Neural plasticity after peripheral nerve injury and regeneration , 2007, Progress in Neurobiology.

[25]  E G Jones,et al.  Thalamic and brainstem contributions to large-scale plasticity of primate somatosensory cortex. , 1998, Science.

[26]  Qing Tian,et al.  Correlation between Choline Signal Intensity and Acetylcholine Level in Different Brain Regions of Rat , 2008, Neurochemical Research.

[27]  T. Elbert,et al.  Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation , 1995, Nature.

[28]  T. Nakaki,et al.  Impaired Glutathione Synthesis in Neurodegeneration , 2013, International journal of molecular sciences.

[29]  Li Xin-tian,et al.  THE DISTRIBUTION OF LEFT AND RIGHT HANDEDNESS IN CHINESE PEOPLE , 1983 .

[30]  E. Taub,et al.  Chronic deafferentation in monkeys differentially affects nociceptive and nonnociceptive pathways distinguished by specific calcium-binding proteins and down-regulates gamma-aminobutyric acid type A receptors at thalamic levels. , 1992, Proceedings of the National Academy of Sciences of the United States of America.

[31]  R. Yezierski,et al.  Proton magnetic resonance spectroscopy of the thalamus in patients with chronic neuropathic pain after spinal cord injury. , 2002, AJNR. American journal of neuroradiology.

[32]  M. H. Ellisman,et al.  Ultrastructure of afferent axon endings in a neuroma , 1991, Journal of neurocytology.

[33]  Yvonne Tran,et al.  Neuro magnetic resonance spectroscopy using wavelet decomposition and statistical testing identifies biochemical changes in people with spinal cord injury and pain , 2010, NeuroImage.

[34]  C. Rae.  A Guide to the Metabolic Pathways and Function of Metabolites Observed in Human Brain 1H Magnetic Resonance Spectra , 2013, Neurochemical Research.