title: Serial assessments of delayed encephalopathy after carbon monoxide poisoning using magnetic resonance spectroscopy and diffusion tensor imaging on 3.0T system.
abstract: To elucidate the still unclear mechanism of delayed encephalopathy after carbon monoxide (CO) poisoning, we serially performed single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) and diffusion tensor imaging (DTI) on a 3.0T system and intelligence tests in 2 patients, while they were undergoing hyperbaric oxygenation therapy. The chronological changes in (1)H-MRS- and DTI-derived parameters indicated the following: (1) White matter demyelination, aerobic metabolism inhibition, and cytotoxic edema persisted for at least 3 months even after starting the hyperbaric oxygenation therapy; (2) the axonal function and structural integrity of the white matter were initially severely impaired and then gradually and partially improved for 5 months, showing changes similar to those in the scores of the intelligence tests. The results demonstrated that brain damage after CO poisoning may persist longer than expected, and that the (1)H-MRS- and DTI-derived parameters are good indicators of the clinical progress of a patient. The combination of (1)H-MRS and DTI on a 3.0T system is useful for monitoring the changes in brain damage and the clinical symptoms of patients with delayed encephalopathy after CO poisoning.
authors.affiliation: Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, Niigata, Japan. terajima@bri.niigata-u.ac.jp
authors.forename: Kenshi
authors.initials: K
authors.lastname: Terajima
authors.forename: Hironaka
authors.initials: H
authors.lastname: Igarashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirose
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuzawa
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nishizawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakada
mesh_terms: D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives; D002249:Carbon Monoxide Poisoning / Q000150:complications*; D002794:Choline / Q000378:metabolism; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D002794:Choline