Choline and creatine are not reliable denominators for calculating metabolite ratios in acute ischemic stroke.
OBJECTIVE
Choline and creatine are commonly used as denominators for other metabolites in ischemic stroke spectroscopy, assuming that they do not change. We investigated their concentration variation over time after stroke.


METHODS
Choline and creatine concentrations were measured by proton MR spectroscopic imaging in 51 patients at 5 times up to 3 months after stroke.


RESULTS
Choline and creatine levels changed significantly in the ischemic region. Choline was significantly reduced during the first 2 weeks after stroke onset (P=0.034). Creatine was significantly reduced during the whole period of the study (P=0.011).


CONCLUSIONS
Choline and creatine concentrations are not reliable denominators for metabolite ratios in acute stroke because their levels vary significantly in ischemic brain regions.
Muñoz Maniega
Susana
S
University of Edinburgh, Division of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK. s.m.maniega@ed.ac.uk
Cvoro
Vera
V
Armitage
Paul A
PA
Marshall
Ian
I
Bastin
Mark E
ME
Wardlaw
Joanna M
JM
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001921:Brain / Q000098:blood supply / Q000378:metabolism* / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000378:metabolism*; D002794:Choline / Q000032:analysis / Q000378:metabolism*; D003401:Creatine / Q000032:analysis / Q000378:metabolism*; D015536:Down-Regulation / Q000502:physiology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D015203:Reproducibility of Results; D020521:Stroke / Q000175:diagnosis / Q000378:metabolism*
D015415:Biomarkers; D003401:Creatine; D002794:Choline