Metabolite profile of cerebrospinal fluid in patients with spina bifida: a proton magnetic resonance spectroscopy study.
METHODS
The present study was carried out to assess the metabolic differences between cerebrospinal fluid samples of patients with spina bifida and age-matched control individuals.


OBJECTIVE
To study the metabolite profile of cerebrospinal fluid of patients with spina bifida using proton magnetic resonance spectroscopy, compare the levels of metabolites with controls, establish correlation of underlying neuronal dysfunction with metabolic changes in patients with spina bifida, and evaluate the potential use of this technique as an additional tool for diagnostic assessment.


BACKGROUND
Combination of embryopathy, stretching, ischemia, compression, and trauma is responsible for cord dysfunction in spina bifida. Changes in neuronal metabolism leads to changes in the local milieu of cerebrospinal fluid in the cord. Change in metabolite profile of cerebrospinal fluid in spina bifida in terms of increase in products of anaerobic metabolism, nerve membrane integrity, and nerve ischemia has not yet been studied.


METHODS
Cerebrospinal fluid obtained from patients and control individuals were characterized using various one- and two-dimensional proton magnetic resonance spectroscopy techniques. Concentration of various metabolites was calculated using the area under the nuclear magnetic resonance peak.


RESULTS
Statistically significantly higher levels of lactate, choline, glycerophosphocholine, acetate, and alanine in the cerebrospinal fluid of patients with spina bifida was observed compared with control individuals.


CONCLUSIONS
Significantly higher levels of metabolites were observed in patients with spina bifida, representing a state of nerve ischemia, anaerobic metabolism, and disruption of neuronal membrane.
Pal
Kamalesh
K
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Sharma
Uma
U
Gupta
D K
DK
Pratap
Akshay
A
Jagannathan
N R
NR
D000085:Acetates / Q000032:analysis / Q000378:metabolism; D000409:Alanine / Q000032:analysis / Q000378:metabolism; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000166:cytology / Q000378:metabolism*; D002675:Child, Preschool; D002794:Choline / Q000032:analysis / Q000378:metabolism; D005260:Female; D005997:Glycerylphosphorylcholine / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000032:analysis / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008591:Meningomyelocele / Q000134:cerebrospinal fluid* / Q000473:pathology; D016135:Spinal Dysraphism / Q000134:cerebrospinal fluid* / Q000473:pathology / Q000601:surgery
D000085:Acetates; D019344:Lactic Acid; D005997:Glycerylphosphorylcholine; D002794:Choline; D000409:Alanine