151. Regional differences in osmotic behavior in brain during acute hyponatremia: an in vivo MRI-study of brain and skeletal muscle in pigs
- Author
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Martin Broch-Lips, Christian Overgaard-Steensen, Jørgen Frøkiær, Troels Ring, Hans Stødkilde-Jørgensen, Else Tønnesen, and Anders Larsson
- Subjects
medicine.medical_specialty ,Osmosis ,Radioisotope Dilution Technique ,Time Factors ,Physiology ,Swine ,Sodium ,Central nervous system ,chemistry.chemical_element ,Brain Edema ,White matter ,Physiology (medical) ,Internal medicine ,Edema ,medicine ,Animals ,Water intoxication ,Deuterium Oxide ,Muscle, Skeletal ,Chemistry ,Osmolar Concentration ,Skeletal muscle ,Brain ,Reproducibility of Results ,Extracellular Fluid ,medicine.disease ,Magnetic Resonance Imaging ,Disease Models, Animal ,medicine.anatomical_structure ,Endocrinology ,Acute Disease ,Potassium ,Female ,medicine.symptom ,Hyponatremia ,Homeostasis - Abstract
Brain edema is suggested to be the principal mechanism underlying the symptoms in acute hyponatremia. Identification of the mechanisms responsible for global and regional cerebral water homeostasis during hyponatremia is, therefore, of utmost importance. To examine the osmotic behavior of different brain regions and muscles, in vivo-determined water content (WC) was related to plasma sodium concentration ([Na+]) and brain/muscle electrolyte content. Acute hyponatremia was induced with desmopressin acetate and infusion of a 2.5% glucose solution in anesthetized pigs. WC in different brain regions and skeletal muscle was estimated in vivo from T1 maps determined by magnetic resonance imaging (MRI). WC, expressed in gram water per 100 g dry weight, increased significantly in slices of the whole brain [342(SD = 14) to 363(SD = 21)] (6%), thalamus [277(SD = 13) to 311(SD = 24)] (12%) and white matter [219(SD = 7) to 225(SD = 5)] (3%). However, the WC increase in the whole brain and white mater WC was less than expected from perfect osmotic behavior, whereas in the thalamus, the water increase was as expected. Brain sodium content was significantly reduced. Muscle WC changed passively with plasma [Na+]. WC determined with deuterium dilution and tissue lyophilzation correlated well with MRI-determined WC. In conclusion, acute hyponatremia induces brain and muscle edema. In the brain as a whole and in the thalamus, regulatory volume decrease (RVD) is unlikely to occur. However, RVD may, in part, explain the observed lower WC in white matter. This may play a potential role in osmotic demyelination.
- Published
- 2010