title: Comparison of regional cerebral blood flow responses to hypoglycemia using pulsed arterial spin labeling and positron emission tomography.
abstract: Different brain regions sense and modulate the counterregulatory responses that can occur in response to declining plasma glucose levels. The aim of this study was to determine if changes in regional cerebral blood flow (rCBF) during hypoglycemia relative to euglycemia are similar for two imaging modalities-pulsed arterial spin labeling magnetic resonance imaging (PASL-MRI) and positron emission tomography (PET). Nine healthy non-diabetic participants underwent a hyperinsulinemic euglycemic (92±3 mg/dL) - hypoglycemic (53±1 mg/dL) clamp. Counterregulatory hormone levels were collected at each of these glycemic levels and rCBF measurements within the previously described network of hypoglycemia-responsive regions (thalamus, medial prefrontal cortex and globus pallidum) were obtained using PASL-MRI and [(15)O] water PET. In response to hypoglycemia, rCBF was significantly increased in the thalamus, medial prefrontal cortex, and globus pallidum compared to euglycemia for both PASL-MRI and PET methodologies. Both imaging techniques found similar increases in rCBF in the thalamus, medial prefrontal cortex, and globus pallidum in response to hypoglycemia. These brain regions may be involved in the physiologic and symptom responses to hypoglycemia. Compared to PET, PASL-MRI may provide a less invasive, less expensive method for assessing changes in rCBF during hypoglycemia without radiation exposure.
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA. arbelaez_a@kids.wustl.edu
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Arbeláez
authors.forename: Yi
authors.initials: Y
authors.lastname: Su
authors.forename: Jewell B
authors.initials: JB
authors.lastname: Thomas
authors.forename: Amy C
authors.initials: AC
authors.lastname: Hauch
authors.forename: Tamara
authors.initials: T
authors.lastname: Hershey
authors.forename: Beau M
authors.initials: BM
authors.lastname: Ances
mesh_terms: D000328:Adult; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*
references.citation: J Comput Assist Tomogr. 1992 Jul-Aug;16(4):620-33
references.pmid: 1629424
references.citation: Diabetes. 1984 Aug;33(8):732-7
references.pmid: 6378698
references.citation: N Engl J Med. 1983 Mar 3;308(9):485-91
references.pmid: 6337335
references.citation: AJNR Am J Neuroradiol. 2008 Aug;29(7):1235-41
references.pmid: 18356467
references.citation: Nucl Med Biol. 2005 Aug;32(6):567-72
references.pmid: 16026703
references.citation: Biochim Biophys Acta. 1982 Feb 2;714(2):265-70
references.pmid: 6275909
references.citation: Diabetes Care. 2009 Aug;32(8):1357-63
references.pmid: 19638522
references.citation: Endocrinology. 2012 Apr;153(4):1908-14
references.pmid: 22396449
references.citation: Neuroimage. 2006 Jul 1;31(3):968-80
references.pmid: 16530430
references.citation: Cereb Cortex. 2004 Jan;14(1):11-22
references.pmid: 14654453
references.citation: Brain. 2003 Oct;126(Pt 10):2139-52
references.pmid: 12821513
references.citation: J Cereb Blood Flow Metab. 2012 Nov;32(11):2084-90
references.pmid: 22892724
references.citation: Proc Natl Acad Sci U S A. 2004 Apr 20;101(16):6217-21
references.pmid: 15026569
references.citation: Proc Natl Acad Sci U S A. 1998 Feb 3;95(3):765-72
references.pmid: 9448239
references.citation: Diabetes. 2008 Feb;57(2):470-5
references.pmid: 18003752
references.citation: J Nucl Med. 1983 Sep;24(9):790-8
references.pmid: 6604140
references.citation: Diabetes. 1993 Dec;42(12):1791-8
references.pmid: 8243825
references.citation: Cereb Cortex. 2000 Mar;10(3):206-19
references.pmid: 10731217
references.citation: Science. 1979 Aug 17;205(4407):723-5
references.pmid: 462184
references.citation: Diabetes Care. 2012 Dec;35(12):2570-4
references.pmid: 22891254
references.citation: Diabetes. 2008 Dec;57(12):3169-76
references.pmid: 19033403
references.citation: Ann N Y Acad Sci. 1999 Jun 29;877:383-96
references.pmid: 10415660
references.citation: Diabetes. 2009 Feb;58(2):448-52
references.pmid: 19017765
references.citation: Stroke. 2005 Sep;36(9):e83-99
references.pmid: 16100027
references.citation: AJNR Am J Neuroradiol. 2008 Sep;29(8):1428-35
references.pmid: 18356466
references.citation: Magn Reson Imaging Clin N Am. 2009 May;17(2):315-38
references.pmid: 19406361
references.citation: J Lab Clin Med. 1985 Dec;106(6):624-9
references.pmid: 4067376
references.citation: J Cereb Blood Flow Metab. 1994 Jul;14(4):628-38
references.pmid: 8014210
references.citation: J Cereb Blood Flow Metab. 1987 Aug;7(4):513-6
references.pmid: 3497165
references.citation: J Comput Assist Tomogr. 1995 Mar-Apr;19(2):289-96
references.pmid: 7890857
references.citation: J Nucl Med. 1983 Sep;24(9):782-9
references.pmid: 6604139
references.citation: Neuron. 2002 Jan 31;33(3):341-55
references.pmid: 11832223
references.citation: Am J Physiol. 1996 Feb;270(2 Pt 2):H554-9
references.pmid: 8779830
references.citation: J Neurophysiol. 2009 Jun;101(6):3270-83
references.pmid: 19339462
references.citation: Magn Reson Med. 2003 May;49(5):796-802
references.pmid: 12704760
references.citation: J Physiol. 1998 Oct 15;512 ( Pt 2):555-66
references.pmid: 9763643
references.citation: Int J Biomed Imaging. 2008;2008:516359
references.pmid: 18825270
references.citation: Neuroimage. 2010 Nov 1;53(2):584-92
references.pmid: 20600990
references.citation: Magn Reson Imaging. 2008 Feb;26(2):261-9
references.pmid: 17826940
references.citation: Curr Opin Neurol. 2009 Aug;22(4):348-55
references.pmid: 19491678
references.citation: BMC Neurosci. 2003 Oct 10;4:25
references.pmid: 14536022