Magnetic resonance spectroscopy study of glycine pathways in nonketotic hyperglycinemia.
Nonketotic hyperglycinemia is a life-threatening disorder in neonates characterized by a deficiency of the glycine cleavage system. We report on four cases of the neonatal form of the disease, which were investigated by in vitro(1)H magnetic resonance spectroscopy of blood and cerebrospinal fluid, and in vivo(1)H magnetic resonance spectroscopy of brain. The existence of glycine disposal pathways leading to an increase in lactate in fluids and creatine in fluids and brain was demonstrated. This is the first observation of elevated creatine in brain in nonketotic hyperglycinemia. A recurrent decrease of glutamine and citrate was observed in cerebrospinal fluid, which might be related to abnormal glutamine metabolism in brain. Finally, the cerebral N-acetylaspartate to myo-inositol-glycine ratio was identified as a prognostic indicator of the disease.
Viola
Angèle
A
Center for Magnetic Resonance in Biology and Medicine CRMBM-UMR-CNRS 6612, Faculty of Medicine, Marseille, France.
Chabrol
Brigitte
B
Nicoli
François
F
Confort-Gouny
Sylviane
S
Viout
Patrick
P
Cozzone
Patrick J
PJ
D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D001921:Brain / Q000378:metabolism / Q000473:pathology; D002675:Child, Preschool; D003915:Dextromethorphan / Q000627:therapeutic use; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D005998:Glycine / Q000097:blood* / Q000134:cerebrospinal fluid*; D006801:Humans; D020158:Hyperglycinemia, Nonketotic / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D007223:Infant; D007294:Inositol / Q000032:analysis; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D011379:Prognosis; D020160:Sodium Benzoate / Q000627:therapeutic use
D018691:Excitatory Amino Acid Antagonists; D001224:Aspartic Acid; D007294:Inositol; D003915:Dextromethorphan; C000179:N-acetylaspartate; D020160:Sodium Benzoate; D005998:Glycine