This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by de Crespigny, A. J. Articles by Hoehn, M. Search for Related Content PubMed PubMed Citation Articles by de Crespigny, A. J. Articles by Hoehn, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Hypoglycemia Transient Ischemic Attack Hazardous Substances DB OXYGEN TETRODOTOXIN Related Collections Animal models of human disease Brain Circulation and Metabolism Ion channels/membrane transport Computerized tomography and Magnetic Resonance Imaging

(Stroke. 1999;30:2212-2222.)
© 1999 American Heart Association, Inc.

Original Contributions

Rapid Monitoring of Diffusion, DC Potential, and Blood Oxygenation Changes During Global Ischemia

Effects of Hypoglycemia, Hyperglycemia, and TTX

A. J. de Crespigny, PhD; J. Röther, MD; C. Beaulieu, PhD M. E. Moseley, PhD

From the Department of Radiology (A.J.de C., J.R., C.B., M.E.M.), Stanford University, Palo Alto, Calif, and the Department of Neurology (J.R.), Friedrich Schiller University, Jena, FRG.

Correspondence to Alex de Crespigny, PhD, Stanford University School of Medicine, Lucas MRS Imaging Center, 1201 Welch Rd, Mail Code 5488, Stanford, CA 94305-5488.. E-mail alex{at}s-word.stanford.edu

Background and Purpose—The increasing interest in diffusion-weighted MRI (MRI) for diagnosis and monitoring of acute stroke in humans calls for a sound understanding of the underlying mechanisms of this image contrast in acute cerebral ischemia. The present study aimed to show that a rapid decrease in brain-water apparent diffusion coefficient (ADC) occurs coincident with anoxic depolarization and that this change is delayed by hyperglycemia and sodium channel blockade but accelerated by hypoglycemia.

Methods—Rats were divided into groups: normoglycemic, hypoglycemic, and hyperglycemic, and those given local tetrodotoxin (TTX) application. Cardiac arrest was effected by intravenous KCl injection during serial high-speed diffusion and blood oxygenation–sensitive gradient-recalled echo MRI. Brain DC potential was recorded simultaneously. Serial ADC maps were calculated from the diffusion-weighted data and fitted to a model function to measure the delay between cardiac arrest and rapid ADC decrease.

Results—The time of anoxic depolarization indicated by DC change agreed well with the rapid drop in ADC in all groups; both were accelerated with hypoglycemia and delayed by hyperglycemia. A more gradual ADC decline occurred before anoxic depolarization, which was more pronounced in hyperglycemic animals and less pronounced in hypoglycemic animals. Rapid drop in ADC was also delayed by local TTX application. Changes in gradient-recalled echo image intensity were not significantly different among groups.

Conclusions—While much of the ADC decrease in ischemia occurs during anoxic depolarization, significant but gradual ADC changes occur earlier that may not be due to a massive loss in ion homeostasis.

Editorial Comment

Effects of Hypoglycemia, Hyperglycemia, and TTX

Mathias Hoehn, PD Dr, Guest Editor

Max-Planck-Institute for Neurological Research, Cologne, Germany

This article has been cited by other articles:

				J. Bottcher, A. Kunze, C. Kurrat, P. Schmidt, G. Hagemann, O.W. Witte, and W.A. Kaiser Localized Reversible Reduction of Apparent Diffusion Coefficient in Transient Hypoglycemia-Induced Hemiparesis Stroke, March 1, 2005; 36(3): e20 - e22. [Abstract] [Full Text] [PDF]

				R. Leigh, O. O. Zaidat, M. F. Suri, G. Lynch, S. Sundararajan, J. L. Sunshine, R. Tarr, W. Selman, D. M.D. Landis, and J. I. Suarez Predictors of Hyperacute Clinical Worsening in Ischemic Stroke Patients Receiving Thrombolytic Therapy Stroke, August 1, 2004; 35(8): 1903 - 1907. [Abstract] [Full Text] [PDF]

				J. Fiehler Editorial Comment--ADC and Metabolites in Stroke: Even More Confusion About Diffusion? Stroke, July 1, 2003; 34 (7): e87 - e88. [Full Text] [PDF]

				T. Doczi, A. Schwarcz, T. Kucinski, O. Vaterlein, J. Fiehler, B. Eckert, H. Zeumer, V. Glauche, J. Rother, E. Klotz, et al. Correlation of Apparent Diffusion Coefficient and Computed Tomography Density in Acute Ischemic Stroke * Response Stroke, May 1, 2003; 34 (5): e17 - e18. [Full Text] [PDF]

				G.-F. Tian and A. J. Baker Protective Effect of High Glucose Against Ischemia-Induced Synaptic Transmission Damage in Rat Hippocampal Slices J Neurophysiol, July 1, 2002; 88(1): 236 - 248. [Abstract] [Full Text] [PDF]

				T. Kucinski, O. Vaterlein, V. Glauche, J. Fiehler, E. Klotz, B. Eckert, C. Koch, J. Rother, and H. Zeumer Correlation of Apparent Diffusion Coefficient and Computed Tomography Density in Acute Ischemic Stroke Stroke, July 1, 2002; 33(7): 1786 - 1791. [Abstract] [Full Text] [PDF]

				T. A. Kent, V. M. Soukup, and R. H. Fabian Heterogeneity Affecting Outcome From Acute Stroke Therapy: Making Reperfusion Worse Stroke, October 1, 2001; 32(10): 2318 - 2327. [Abstract] [Full Text] [PDF]

				S. Condette-Auliac, S. Bracard, R. Anxionnat, E. Schmitt, J. C. Lacour, M. Braun, J. Meloneto, A. Cordebar, L. Yin, and L. Picard Vasospasm After Subarachnoid Hemorrhage: Interest in Diffusion-Weighted MR Imaging Stroke, August 1, 2001; 32(8): 1818 - 1824. [Abstract] [Full Text] [PDF]