MELAS: Monitoring treatment with magnetic resonance spectroscopy

Acta Neurologica Scandinavica
Dominic A HovsepianCatherine Yim

Abstract

To assess the utility of Magnetic Resonance Spectroscopy (MRS) as a biomarker of response to L-arginine in mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). To describe a case of MELAS treated with L-arginine that showed improvement clinically and on serial MRS METHODS: MRS was performed on a 1.5-Tesla scanner to evaluate a MELAS patient before, during, and after intravenous (IV) L-arginine therapy for the treatment of stroke-like episodes. L-arginine was infused at a dose of 500 mg/kg daily for 7 days followed by oral arginine therapy. The patient had clinical improvement after treatment with IV L-arginine. MRS performed before, during, and after treatment with IV L-arginine showed significant improvement in brain lactate and increase in the N-acetylaspartate/Choline (NAA/Cho) ratio compared to pre-treatment baseline. Serial MRS imaging showed significant improvement in lactate peaks and NAA/Cho ratios that corresponded with clinical improvement after L-arginine therapy. Given this correlation between radiologic and clinical improvement, MRS may be a useful biomarker assessing response to treatment in MELAS.

References

Mar 1, 1975·Lancet·B Jennett, M Bond
May 1, 1988·Stroke; a Journal of Cerebral Circulation·J C van SwietenJ van Gijn
Nov 1, 1995·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·N De StefanoD L Arnold
Jun 17, 1998·Archives of Neurology·S G PavlakisD Lustbader
Sep 8, 2004·Brain & Development·Masaya KubotaMariko Momoi-Yoshida
Mar 12, 2005·Journal of the Neurological Sciences·Harald E MöllerBarbara Fiedler
Feb 6, 2007·Mitochondrion·Yasutoshi KogaToyojiro Matsuishi
Jan 28, 2009·Brain & Development·Tetsuya TsujikawaHirohiko Kimura
Jun 23, 2015·Molecular Genetics and Metabolism·Ayman W El-HattabFernando Scaglia
Jun 24, 2016·Journal of Neurology·Miyuki KitamuraYasutoshi Koga

❮ Previous
Next ❯

Citations

Nov 7, 2019·Current Opinion in Clinical Nutrition and Metabolic Care·Masamichi IkawaYasutoshi Koga
Jun 6, 2019·Acta Diabetologica·Josef Finsterer
Aug 23, 2019·Current Opinion in Ophthalmology·Eloise WatsonClare L Fraser
May 6, 2021·Annals of Clinical and Translational Neurology·Laura L GramegnaRaffaele Lodi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.