Imaging of glutamate in acute carbon monoxide poisoning using chemical exchange saturation transfer

Hongyi Zheng; Wenbin Zheng; Hongkun Liu; Gengbiao Zhang; Weijia Li; Jiayan Zhuang; Yuelin Guo

doi:10.3389/fneur.2023.1065490

Imaging of glutamate in acute carbon monoxide poisoning using chemical exchange saturation transfer

Front Neurol. 2023 Feb 2:14:1065490. doi: 10.3389/fneur.2023.1065490. eCollection 2023.

Authors

Hongyi Zheng¹, Wenbin Zheng¹, Hongkun Liu², Gengbiao Zhang¹, Weijia Li¹, Jiayan Zhuang¹, Yuelin Guo³

Affiliations

¹ Department of Radiology, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China.
² Department of Radiology, Huizhou City Center People's Hospital, Huizhou, China.
³ Department of Radiology, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China.

Abstract

Aims: This study adopted the Glutamate Chemical Exchange Saturation Transfer (GluCEST) imaging technique to quantitatively analyze cranial glutamate and discussed the effectiveness of GluCEST values in identifying the pathogenesis of encephalopathy after CO poisoning.

Methods: The routine MRI and functional MRI scans of two cohorts of subjects (CO group, n = 29; Control group, n = 21) were performed. Between-group comparisons were conducted for GluCEST% in regions of interest (ROI), including the basal ganglia, the thalamus, the frontal lobe, the occipital lobe, the genu of corpus callosum, the cingulate gyrus, and the cuneus. Moreover, an age-stratified subgroup analysis was devised, and a correlational analysis was performed for GluCEST% in each ROI, including the time in coma, Simple Mini-Mental State Examination Scale (MMSE) score, Hamilton Anxiety Scale score, and blood COHb%.

Results: As compared to the healthy control, the CO group led to significantly increasing GluCEST% in the basal ganglia, the occipital lobe, the genu of the corpus callosum, the cingulate gyrus, and the cuneus (p < 0.05). In the subgroup analysis for age, adult patients had higher GluCEST% in the basal ganglia, the thalamus, the occipital lobe, the cingulate gyrus, and the cuneus compared to healthy adults (p < 0.05). In addition, the correlational analysis of CO-poisoned patients revealed a statistical association between the GluCEST% and the MMSE in the thalamus and the genu of the corpus callosum.

Conclusion: The GluCEST technique is superior to routine MRI in that it can identify the cerebral biochemical changes sooner after acute CO poisoning, which is significant for our understanding of the role of neurotransmitters in the pathological basis of this disease. Brain injury caused by CO poisoning may be different in adults and children.

Keywords: CO poisoning; GluCEST; carbon monoxide poisoning; chemical exchange saturation transfer; glutamate.

Grants and funding

This study was funded by the Joint Research Fund for Enterprise and Basic and Applied Basic Research Programs of Guangdong Province of China (Grant No. 2021A1515 220112), the 2019 Li Ka Shing Foundation Cross-Disciplinary Research Grant, and the 2020 Basic Research General Project of the Shenzhen Science and Technology Innovation Commission Program grant awarded to WZ, a research grant awarded by the Natural Science Foundation of Shenzhen (JCYJ20190808095403639) to YG, and the grants by the 2023 Medical Scientific Research Foundation of Guangdong Province, China and the Foundation of 2022 Medical and Health Science and Technology Project of Shantou City (Grant No. [2022]169-44), Guangdong Province, China awarded to HZ.