Simultaneous Measurement of Glutathione and Other Metabolites in Stroke Patients by J-Difference Spectroscopy

Introduction: As a free radical scavenger and non-enzymatic anti-oxidant, reduced glutathione (GSH) plays a major role in the defense against reactive oxygen species in the human brain. Acute ischemic stroke is associated with significant oxidative stress and subsequent precipitates changes in the glutathione system. Clinical studies have shown that subjects with risk factors for stroke have relatively low levels of GSH, and patients with acute ischemic stroke develop elevated blood GSH levels during the first hours to days post ictus [1]. However methodological issues mean that most previous studies of the GSH system in stroke have focused on changes in the blood or urine. In vivo measurement of GSH in stroke patients by magnetic resonance spectroscopy (MRS) can provide spatially localized GSH levels in lesion and normal brain tissue. We have demonstrated the feasibility of measuring GSH in stroke patients by using a J-difference spectroscopy technique [2] with an improved data post-processing algorithm [3]. In this study we used this technique to investigate the changes in brain GSH occurring after stroke, with respect to changes in other commonly measured metabolites: choline (Cho), creatine/phosphocreatine (Cr), N-acetyl-aspartate (NAA), and lactate (Lac).