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Metabolomic Analysis of Cerebral Spinal Fluid from Patients with Severe Brain Injury

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Book cover Brain Edema XV

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 118))

Abstract

Proton nuclear magnetic resonance (H-NMR) spectroscopic analysis of cerebral spinal fluid provides a quick, non-invasive modality for evaluating the metabolic activity of brain-injured patients. In a prospective study, we compared the CSF of 44 TBI patients and 13 non-injured control subjects. CSF was screened for ten parameters: β-glucose (Glu), lactate (Lac), propylene glycol (PG), glutamine (Gln), alanine (Ala), α-glucose (A-Glu), pyruvate (PYR), creatine (Cr), creatinine (Crt), and acetate (Ace). Using mixed effects measures, we discovered statistically significant differences between control and trauma concentrations (mM). TBI patients had significantly higher concentrations of PG, while statistical trends existed for lactate, glutamine, and creatine. TBI patients had a significantly decreased concentration of total creatinine. There were no significant differences between TBI patients and non-injured controls regarding β- or α-glucose, alanine, pyruvate or acetate. Correlational analysis between metabolites revealed that the strongest significant correlations in non-injured subjects were between β- and α-glucose (r = 0.74), creatinine and pyruvate (r = 0.74), alanine and creatine (r = 0.62), and glutamine and α-glucose (r = 0.60). For TBI patients, the strongest significant correlations were between lactate and α-glucose (r = 0.54), lactate and alanine (r = 0.53), and α-glucose and alanine (r = 0.48). The GLM and multimodel inference indicated that the combined metabolites of PG, glutamine, α-glucose, and creatinine were the strongest predictors for CMRO2, ICP, and GOSe. By analyzing the CSF of patients with TBI, our goal was to create a metabolomic fingerprint for brain injury.

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Acknowledgments

The authors would like to acknowledge and thank the ICU staff of the Ronald Reagan UCLA Medical Center. Financial support was provided from the University of California Neurotrauma Initiative, the UCLA Brain Injury Research Center, The MacDonald Family Grant, The Baskin and Bronson Family Foundation, Evelyn Freed, and NINDS: PO1NS058489, 1R21NS055902, 1R21NS057252.

Conflict of InterestWe declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095-7039, USA

    Thomas C. Glenn, Daniel Hirt, Gustavo Mendez, David L. McArthur, Rachael Sturtevant, Stephanie Wolahan, Farbod Fazlollahi, Matthew Ordon, Arzu Bilgin-Freiert, Paul Vespa, David A. Hovda & Neil A. Martin

  2. UCLA Radiological Sciences, 924 Westwood Blvd Ste 615, Los Angeles, CA, 90095-7319, USA

    Ben Ellingson

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  1. Thomas C. Glenn
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  2. Daniel Hirt
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Corresponding author

Correspondence to Thomas C. Glenn .

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Editors and Affiliations

  1. School of Medicine, Dept. Neurological Surgery, Nihon University, Oyaguchikami-machi 30-1, Tokyo, 173-8610, Japan

    Yoichi Katayama

  2. School of Medicine, Departments of Neurological Surgery and, Nihon University, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan

    Takeshi Maeda

  3. , Department of Clinical Laboratory, Namegata District General Hospital, 98-8 Inouefujii, Namegata 98-8, Ibaraki, 311-3516, Japan

    Toshihiko Kuroiwa

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Glenn, T.C. et al. (2013). Metabolomic Analysis of Cerebral Spinal Fluid from Patients with Severe Brain Injury. In: Katayama, Y., Maeda, T., Kuroiwa, T. (eds) Brain Edema XV. Acta Neurochirurgica Supplement, vol 118. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1434-6_20

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  • DOI: https://doi.org/10.1007/978-3-7091-1434-6_20

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1433-9

  • Online ISBN: 978-3-7091-1434-6

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