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Muscle Metabolites: Functional MR Spectroscopy during Exercise Imposed by Tetanic Electrical Nerve Stimulation¹

¹ From the Departments of Neurology (A.C.N., K.M.R.) and Neuroradiology (J.S.), University Hospital, Inselspital, CH-3010 Bern, Switzerland. Received March 23, 2005; revision requested May 25; revision received October 25; accepted November 23; final version accepted December 15. Supported by the Departments of Neurology and Neuroradiology of the University Hospital of Bern, Switzerland, and by the Swiss National Science Foundation (SNF grant 3200B0-107499). Address correspondence to A.C.N. (e-mail: anirkko{at}insel.ch).

Permission from the ethics committee and informed consent were obtained. The purpose of this study was to prospectively evaluate a method developed for the noninvasive assessment of muscle metabolites during exercise. Hydrogen 1 magnetic resonance (MR) spectroscopy peaks were measured during tetanic isometric muscle contraction imposed by supramaximal repetitive nerve stimulation. The kinetics of creatine-phosphocreatine and acetylcarnitine signal changes (P < .001) could be assessed continuously before, during, and after exercise. The control peak (trimethylammonium compounds), which served as an internal reference, did not change. This technique—that is, functional MR spectroscopy—opens the possibility for noninvasive diagnostic muscle metabolite testing in a clinical setting.

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