Clinical trial NCT00109174: MRS Measurement of Glutamate and GABA Metabolism in Brain
Official title: MRS (Magnetic Resonance Spectroscopy) Measurement of Glutamate and GABA Metabolism in Brain
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Normal Physiology
Keywords: Glutamate
Excitatory Amino Acid
Neurochemistry
Brain
Magnetic Resonance Spectroscopy
Lead sponsor: National Institutes of Health Clinical Center (CC)
Sponsor class: NIH
First posted: 2005-04-25
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: BASIC_SCIENCE

Brief summary: This study will use magnetic resonance spectroscopy (MRS) to measure in the brain the transfer of \[13\]C as it is naturally metabolized from glucose to specific chemical transmitters. From this method, we can measure the rate of production of an important excitatory neurotransmitter (glutamate) as well as an inhibitory neurotransmitter (GABA)....

Detailed description: 13C is a stable (i.e., non-radioactive) isotope of carbon with a natural abundance of \~1%. Following infusion of \[13C\]glucose and/or \[13C\]acetate, in vivo MRS (magnetic resonance spectroscopy) can monitor the rate of flux of the 13C atom from glucose and/or acetate to glutamate to glutamine. Thus, this procedure can provide measure of glutamate (GLU) and glutamine (GLN) turnover in brain. We have established parameters to obtain these measurements in nonhuman primate brain. The current protocol seeks approval to optimize MRS parameters and to develop new MRS techniques for human brain using the GE 3T, the Siemens 3T, and the Siemens 7T device.

Study population: All subjects will be aged 18 65 years, without serious medical illnesses and meet criteria listed in Section VI A.

Design: Subjects will receive either oral administration of \[13C\]glucose or an intravenous infusion of \[13C\]glucose and/or \[13C\]acetate to approximately double their plasma glucose levels. The plasma acetate level will remain within the physiological range observed in humans (Lebon et al, 2002). While lying in the 3T or 7T device, serial data acquisitions will be obtained over \~2 h to optimize the experimental conditions so as to measure the 13C signals from GLU, GLN and other metabolisms in brain.

Outcome measures: The primary goal of this study is to measure GLU/GLN turnover in brain. With no additional data acquisition, we can also obtain information on the synthesis of GABA, the major inhibitory neurotransmitter in brain. GLU is converted to GABA via the enzyme glutamic acid decarboxylase (GAD). While monitoring the transfer of 13C signal from GLU to GLN, we can simultaneously measure the transfer of 13C signal from GLU to GABA and thereby measure the activity of GAD (Li et al 2005). In addition to directly measure 13C signals, 13C labeling to brain metabolites can also be measured indirectly by detecting proton MRS during infusion of \[13C\]glucose and/or \[13C\]acetate.

Eligibility criteria: * INCLUSION CRITERIA:
* 18-65 years of age
* Able to give written informed consent
* Healthy based on medical history and physical exam
* Enrolled in Protocol 01-M-0254 or Protocol 17-M-0181

EXCLUSION CRITERIA:

* Any current Axis 1 diagnosis
* Clinically significant laboratory abnormalities
* Positive HIV test
* Metallic foreign bodies that would be affected by the magnetic resonance imaging (MRI) magnet, or fear of enclosed spaces likely to make the subject unable to undergo an MRI scan.
* History of neurological illness or injury with the potential to affect study data interpretation, such as multiple sclerosis, Parkinson s disease, seizure disorder or traumatic brain injury
* Prescription psychotropic medication; drug free less than 8 weeks (anticholinergics, benzodiazepine, fluoxetine, antipsychotics, and anticonvulsants)
* Serious medical illness as determined from H\&P or laboratory testing including Diabetes
* Inability to lie flat on camera bed for about two and a half hours
* Pregnant or breastfeeding
* Current substance use disorder based on DSM-5
* NIMH employees and staff and their immediate family members will be excluded from the study per NIMH policy.

Primary outcomes:
measure: The primary outcome is the quality of the MR spectroscopy which includes spectrum signal-to-noise (SNR)\ ratio, spectral lineshape, linewidth, and resolution.
timeFrame: prospective and ongoing
Secondary outcomes:
measure: The secondary outcome is the performance improvements of the scanner hardware, software and methodology
timeFrame: prospective and ongoing
Other outcomes:
Locations:
city: Bethesda
country: United States
facility: National Institutes of Health Clinical Center
state: Maryland
Study officials:
affiliation: National Institute of Mental Health (NIMH)
name: Li An, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: