An integrated strategy for evaluation of metabolic and oxidative defects in neurodegenerative illness using magnetic resonance techniques

The number of physiologic and metabolic phenomena amenable to analysis using magnetic resonance (MR) techniques is increasing every year. MR techniques tan now evalutate tissue parameters relevant to TCA. cyclemetabolism, anerobic glycolysis, ATP levels, blood-brain barrier permeability, macrophage infiltration, cytotoxic edema, spreading depression, cerebral blood now and volume, and neurotransmitter function. The paramagnetic nature of certain oxidation states of iron leads to the ability to map out brain function using deoxyhemoglobin as an endogenous contrast agent, and also allows for mapping of local tissue iran concentrations. Zn addtion to these metabolic parameters, the number of ways to generate anatomic contrast using MR is also expanding; and In addition to conventional anatomic scans, mapping of axonal fiber tracts can also be performed using the anisotropy of eater diffusion, rt strategy for integration of these multifarious parameters in a comprehensive neurofunctional exam in neurodegenerative illness is outlined in this paper. The goals of the integrated exam, as applied to a given neurodegenerative illness, can be subdivided into three categories: etiology, natural history, and therapeutic end points, The consequences of oxidative stress and/or mitochondrial dysfunction are explored in the contest of the various parameters that can be measured using the integrated MR exam.