Abstract
There is an evidence of neurocognitive dysfunction even in the absence of advanced liver disease in chronic hepatitis C virus (HCV) infection. Brain metabolism has been investigated non-invasively using one-dimensional (1D) in vivo Magnetic Resonance Spectroscopy (MRS) over three decades. Even though highly concentrated cerebral metabolites (N-acetylaspartate, creatine, choline, glutamate/glutamine, myo-inositol) have been detected using MRS, other metabolites at low concentrations (~1–3 mM or less) including glutathione, aspartate and GABA are quite difficult to observe using 1D MRS. In order to resolve overlapping resonances from a number of metabolites, a remedy is to add a second spectral dimension to the existing 1D MRS. Localized two-dimensional correlated spectroscopy (L-COSY) has been developed over the last decade to enhance the spectral dispersion by using the second spectral dimension. We have evaluated this L-COSY technique in the frontal white/gray matter regions of 14 HCV+ (mean age of 56.2 years) and 14 HCV− (mean age of 46.6 years) subjects. Our preliminary results showed significantly increased myo-inositol and glutathione in the HCV+ compared to the HCV− subjects. Hence, glutathione and myo-inositol should be considered along with other metabolites as important markers of inflammation.
Highlights
The natural course of Hepatitis C virus (HCV) infection, which is transmitted via parenteral route, is modulated by both host and viral factors and typically tends to evolve towards chronicity, which will ensue in approximately 85% of cases following acute infection [1]
Our results showed significant increase of mI and GSH in the hepatitis C virus (HCV)+ patient group compared to healthy controls and demonstrated that the 2D Magnetic Resonance Spectroscopy (MRS) spectra allowed us to visualize and characterize the role of GSH in cerebral metabolism
Additional findings from this work include the quantitation of GSH, gamma-aminobutyric acid (GABA), Glu, Scy, and Asp using the 2D Localized twodimensional correlated spectroscopy (L-COSY) spectra postprocessed by the prior knowledge fitting (ProFit) algorithm
Summary
The natural course of Hepatitis C virus (HCV) infection, which is transmitted via parenteral route, is modulated by both host and viral factors and typically tends to evolve towards chronicity, which will ensue in approximately 85% of cases following acute infection [1]. Given that this virus affects approximately 3% of the world’s population [2], HCV infection represents a leading cause of chronic hepatitis, cirrhosis, end-stage liver failure, and hepatocellular carcinoma. Subtle cognitive complaints are reported that include difficulties in concentration and slowed processing speed These observations sparked a number of investigations that sought to characterize neuropathological changes in patients with HCV with mild (noncirrhotic) liver disease
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