Proton magnetic resonance spectroscopy of cerebral lactate and other metabolites in stroke patients

Glenn D. Graham, Andrew M. Blamire, Alistair M. Howseman, Douglas L. Rothman, Pierre B. Fayad, Lawrence M. Brass, Ognen A.C. Petroff, Robert G. Shulman, James W. Prichard

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Abstract

Background and Purpose: Proton magnetic resonance spectroscopy can measure in vivo brain lactate and other metabolites noninvasively. We measured the biochemical changes accompanying stroke in 16 human subjects with cortical or deep cerebral infarcts within the first 3 weeks after symptom onset, and performed follow-up studies on six. Methods: One-dimensional proton spectroscopic imaging encompassing the infarct region was performed with a 2.1-T whole-body magnet using the stimulated echo pulse sequence and an echo time of 270 msec. Results: All but one of the cortical stroke patients had increased lactate within or near the infarct. Persistently elevated cerebral lactate was documented in five of six cases studied serially as long as 251 days after infarction. N-acetylaspartate levels were decreased in most cortical strokes. Elevated lactate, accompanied by minimal reduction in N-acetylaspartate, was recorded in two of four patients in the first week following a small subcortical infarct. Conclusions: Long-term elevation of lactate commonly occurs after stroke. This lactate may arise from ongoing ischemia or infiltrating leukocytes, or it may be a residual of the lactate formed during the initial insult. The ability to observe stroke-elevated lactate pools at any time after lesion onset provides an approach to distinguishing among these possibilities in the future.

Original languageEnglish (US)
Pages (from-to)333-340
Number of pages8
JournalStroke
Volume23
Issue number3
DOIs
Publication statusPublished - Mar 1992

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Keywords

  • Cerebral infarction
  • Lactates
  • Nuclear magnetic resonance

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Graham, G. D., Blamire, A. M., Howseman, A. M., Rothman, D. L., Fayad, P. B., Brass, L. M., ... Prichard, J. W. (1992). Proton magnetic resonance spectroscopy of cerebral lactate and other metabolites in stroke patients. Stroke, 23(3), 333-340. https://doi.org/10.1161/01.STR.23.3.333