Brain glucose and acetoacetate metabolism: a comparison of young and older adults |
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Authors: | Scott Nugent Sebastien Tremblay Kewei W. Chen Napatkamon Ayutyanont Auttawut Roontiva Christian-Alexandre Castellano Melanie Fortier Maggie Roy Alexandre Courchesne-Loyer Christian Bocti Martin Lepage Eric Turcotte Tamas Fulop Eric M. Reiman Stephen C. Cunnane |
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Affiliation: | 1. Research Center on Aging, Université de Sherbrooke, Sherbrooke, Quebec, Canada;2. Department of Physiology and Biophysics, Université de Sherbrooke, Sherbrooke, Quebec, Canada;3. Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada;4. Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada;5. Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, Quebec, Canada;6. Banner Alzheimer''s Institute, Phoenix, AZ, USA |
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Abstract: | The extent to which the age-related decline in regional brain glucose uptake also applies to other important brain fuels is presently unknown. Ketones are the brain's major alternative fuel to glucose, so we developed a dual tracer positron emission tomography protocol to quantify and compare regional cerebral metabolic rates for glucose and the ketone, acetoacetate. Twenty healthy young adults (mean age, 26 years) and 24 healthy older adults (mean age, 74 years) were studied. In comparison with younger adults, older adults had 8 ± 6% (mean ± SD) lower cerebral metabolic rates for glucose in gray matter as a whole (p = 0.035), specifically in several frontal, temporal, and subcortical regions, as well as in the cingulate and insula (p ≤ 0.01, false discovery rate correction). The effect of age on cerebral metabolic rates for acetoacetate in gray matter did not reach significance (p = 0.11). Rate constants (min−1) of glucose (Kg) and acetoacetate (Ka) were significantly lower (−11 ± 6%; [p = 0.005], and −19 ± 5%; [p = 0.006], respectively) in older adults compared with younger adults. There were differential effects of age on Kg and Ka as seen by significant interaction effects in the caudate (p = 0.030) and post-central gyrus (p = 0.023). The acetoacetate index, which expresses the scaled residuals of the voxel-wise linear regression of glucose on ketone uptake, identifies regions taking up higher or lower amounts of acetoacetate relative to glucose. The acetoacetate index was higher in the caudate of young adults when compared with older adults (p ≤ 0.05 false discovery rate correction). This study provides new information about glucose and ketone metabolism in the human brain and a comparison of the extent to which their regional use changes during normal aging. |
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Keywords: | Aging Positron emission tomography Magnetic resonance imaging Acetoacetate Brain FDG Ketones |
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