Ornithine transcarbamylase deficiency with persistent abnormality in cerebral glutamate metabolism in adults

Andrea L. Gropman, Napapon Sailasuta, Kent C. Harris, Osama Abulseoud, Brian D. Ross

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To determine cerebral glutamate turnover rate in partial-ornithine transcarbamylase deficiency (OTCD) patients by using carbon 13 (13C) magnetic resonance (MR) spectroscopy. Materials and Methods: The study was performed with approval of the institutional review board, in compliance with HIPAA regulations, and with written informed consent of the subjects. MR imaging, hydrogen 1 (1H) MR spectroscopy, and 13C MR spectroscopy were performed at 1.5 T in 10 subjects, six patients with OTCD and four healthy control subjects, who were in stable condition. Each received intravenous 13C-glucose (0.2 g/kg), C1 or C2 position, as a 15-minute bolus. Cerebral metabolites were determined with proton decoupling in a parieto-occipital region (n = 9) and without proton decoupling in a frontal region (n = 1) during 60-120 minutes. Results: Uptake and removal of cerebral glucose ([1-13C]-glucose or [2-13C]-glucose) were comparable in healthy control subjects and subjects with OTCD (P = .1). Glucose C1 was metabolized to glutamate C4 and glucose C2 was metabolized to glutamate C5 at comparable rates, both of which were significantly reduced in OTCD (combined, P = .04). No significant differences in glutamine formation were found in subjects with OTCD (P = .1). [2-13C]-glucose and its metabolic products were observed in anterior cingulate gyrus without proton decoupling in one subject with OTCD. Conclusion: Treatments that improve cerebral glucose metabolism and glutamate neurotransmission may improve neurologic outcome in patients with OTCD, in whom prevention and treatment of hyperammonemic episodes appear to be insufficient.

Original languageEnglish (US)
Pages (from-to)833-841
Number of pages9
JournalRadiology
Volume252
Issue number3
DOIs
StatePublished - Sep 2009
Externally publishedYes

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Ornithine Carbamoyltransferase Deficiency Disease
Glutamic Acid
Glucose
Protons
Healthy Volunteers
Magnetic Resonance Spectroscopy
Health Insurance Portability and Accountability Act
Occipital Lobe
Research Ethics Committees
Gyrus Cinguli
Glutamine
Informed Consent
Synaptic Transmission
Nervous System
Hydrogen
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Ornithine transcarbamylase deficiency with persistent abnormality in cerebral glutamate metabolism in adults. / Gropman, Andrea L.; Sailasuta, Napapon; Harris, Kent C.; Abulseoud, Osama; Ross, Brian D.

In: Radiology, Vol. 252, No. 3, 09.2009, p. 833-841.

Research output: Contribution to journalArticle

Gropman, Andrea L. ; Sailasuta, Napapon ; Harris, Kent C. ; Abulseoud, Osama ; Ross, Brian D. / Ornithine transcarbamylase deficiency with persistent abnormality in cerebral glutamate metabolism in adults. In: Radiology. 2009 ; Vol. 252, No. 3. pp. 833-841.
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