Altered brain energy metabolism in demented patients with multiple subcortical ischemic lesions. Working hypotheses
G. G. Brown, J. H. Garcia, J. W. Gdowski, S. R. Levine and J. A. Helpern
Department of Neuropsychology, Henry Ford Health Science Center, Detroit, Mich. 48202.
We report the results of brain metabolic studies (using magnetic resonance
spectroscopy) in three groups of individuals: (1) demented patients with
multiple subcortical ischemic lesions (n = 18); (2) nondemented,
age-matched controls (n = 21); and (3) demented patients with
neurodegenerative disease, probably of the Alzheimer type (n = 19).
Patients with dementia with subcortical vascular lesions, as demonstrated
by appropriate imaging studies, had an increase of phosphate energy charge
in areas of the cerebral cortex (especially prominent in the frontal
regions) superficial to and excluded from the subcortical lesions. We
hypothesize that this increased energy charge might be caused by reduced
metabolic activity of disconnected brain tissue or by astrocytic
hypertrophy and hyperplasia that accompanies subtle ischemic, cortical
alterations.
