Modeling of pathophsiological coupling between brain electrical activation, energy metabolism and hemodynamics: insights for the interpretation of intracerebral tumor imaging

摘要

Gliomas can display marked changes in the concentrations of energy metabolism molecules such as creatine (Cr), phosphocreatine (PCr) and lactate, as measured using magnetic resonance spectroscopy (MRS). Moreover, the BOLD (blood oxygen level depedent) contrast enhancement in functional magnetic resonance imaging (fMRI) can be reduced or missing within or near gliomas, while neutral activity is not significantly reduced (so-called neurovascular decoupling), so that the location of functionally loquent areas using fMR can be erroneous. In this paper, we adapt a previously developed model of the coupling between neural activation,energy metabolism and hemodynamics, by including the enous dilatation "Balloon model" of Buxton and Frank. We show that decreasing the cerebral blood flow (CBF) baseline value, or the CBF increase fraction, results in a decrease of the BOLD signal and an increase of the lactate peak during a sustained activation. Baseline lactate and PCr levels are not significantly affected by CBF baseline reduction, but are altered even by a moderate decrease of mitochondrial respiration. Decreasing the tota Cr and PCr concentration reduces the BOLD signal after the initial overshoot. In conclusion, we suggest that the coupled use of BOLD fMRI and MRS could contribute to a better understanding of the neurovascular and metabolic decoupling in gliomas.