In vivo imaging of cerebral glucose metabolism informs on subacute to chronic post-stroke tissue status – A pilot study combining PET and deuterium metabolic imaging

Anu E. Meerwaldt, Milou Straathof, Wija Oosterveld, Caroline L. van Heijningen, Mandy M.T. van Leent, Yohana C. Toner, Jazz Munitz, Abraham J.P. Teunissen, Charlotte C. Daemen, Annette van der Toorn, Gerard van Vliet, Geralda A.F. van Tilborg, Henk M. De Feyter, Robin A. de Graaf, Elly M. Hol, Willem J.M. Mulder, Rick M. Dijkhuizen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Recanalization therapy after acute ischemic stroke enables restoration of cerebral perfusion. However, a significant subset of patients has poor outcome, which may be caused by disruption of cerebral energy metabolism. To assess changes in glucose metabolism subacutely and chronically after recanalization, we applied two complementary imaging techniques, fluorodeoxyglucose (FDG) positron emission tomography (PET) and deuterium (2H) metabolic imaging (DMI), after 60-minute transient middle cerebral artery occlusion (tMCAO) in C57BL/6 mice. Glucose uptake, measured with FDG PET, was reduced at 48 hours after tMCAO and returned to baseline value after 11 days. DMI revealed effective glucose supply as well as elevated lactate production and reduced glutamate/glutamine synthesis in the lesion area at 48 hours post-tMCAO, of which the extent was dependent on stroke severity. A further decrease in oxidative metabolism was evident after 11 days. Immunohistochemistry revealed significant glial activation in and around the lesion, which may play a role in the observed metabolic profiles. Our findings indicate that imaging (altered) active glucose metabolism in and around reperfused stroke lesions can provide substantial information on (secondary) pathophysiological changes in post-ischemic brain tissue.

Original languageEnglish
Pages (from-to)778-790
Number of pages13
JournalJournal of Cerebral Blood Flow and Metabolism
Volume43
Issue number5
DOIs
Publication statusPublished - May 2023

Keywords

  • Cerebral glucose metabolism
  • deuterium metabolic imaging
  • ischemic stroke
  • magnetic resonance imaging/spectroscopy
  • positron emission tomography

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