In chronic hepatic encephalopathy (HE), high ammonium delivery to the brain is causing the accumulation of glutamine (Gln) and gradual release of other osmolytes. We aimed to follow the longitudinal evolution of brain Gln and other metabolite properties in chronic-HE using diffusion-weighted spectroscopy (DW-MRS) and evaluate the potential changes in diffusion behavior which might provide information on Gln localization and potential microstructural alterations during chronic-HE. Increased diffusivity and reduced kurtosis in BDL rats, showcased by DW-MRS analysis, are fully consistent with a less complex microstructure and swollen soma as highlighted by fluorescence and electron microscopy leading to increased molecule mobility.
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