Brain temperature measured by 1H-magnetic resonance spectroscopy in acute and subacute carbon monoxide poisoning
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Brain temperature (BT) is associated with the balance between cerebral blood flow and metabolism according to the “heat-removal” theory. The present study investigated whether BT is abnormally altered in acute and subacute CO-poisoned patients by using 1H-magnetic resonance spectroscopy (MRS).
Eight adult CO-poisoned patients underwent 3-T magnetic resonance imaging in the acute and subacute phases after CO exposure. MRS was performed on deep cerebral white matter in the centrum semiovale, and MRS-based BT was estimated by the chemical shift difference between water and the N-acetyl aspartate signal. We defined the mean BT + 1.96 standard deviations of the BT in 15 healthy controls as the cutoff value for abnormal BT increases (p < 0.05) in CO-poisoned patients.
BT of CO-poisoned patients in both the acute and subacute phases was significantly higher than that of the healthy control group. However, BT in the subacute phase was significantly lower than in the acute phase. On the other hand, no significant difference in body temperature was observed between acute and subacute CO-poisoned patients. BT weakly correlated with body temperature, but this correlation was not statistically significant (rho = 0.304, p = 0.2909).
The present results suggest that BT in CO-poisoned patients is abnormally high in the acute phase and remains abnormal in the subacute phase. BT alteration in these patients may be associated with brain perfusion and metabolism rather than other factors such as systemic inflammation and body temperature.
KeywordsCO poisoning Brain temperature Magnetic resonance spectroscopy Brain metabolism Delayed neuropsychiatric sequelae
We appreciate the supports of members of the Department of Psychiatry and Department of Neurology of Iwate Medical University, and members of Iwate Prefectural Advanced Critical Care and Emergency (Morioka, Iwate, Japan). We also appreciate the support of Dr. Makoto Sasaki (M.D., Ph.D.) and Yutaka Matsumura (R.T.) of Iwate Medical University. This work was partly supported in part by the following grants: Grant-in-Aid for Scientific Research (C) (No. 22592020, 2012–2014 and No. 15K09935, 2015–2018) and Grant-in-Aid for Strategic Medical Science Research (S1491001, 2014–2018) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
Compliance with ethical standards
We declare that all human and animal studies have been approved by the Ethics Committee at Iwate Medical University (Morioka, Japan) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
Conflict of interest
We declare that we have no conflict of interest.
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