{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:22Z","timestamp":1787018122394,"version":"build-2736575974"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>\n                      Chronic cerebral hemodynamic impairment due to high-grade occlusive carotid disease may lead to compromised energy metabolism. This might result in chronic subtle tissue damage, even in patients without overt brain infarction. The aim of this study was to investigate hypoperfusion-related changes of cerebral energy metabolism and their potential restitution after revascularization. For this purpose, 3-dimensional\n                      <jats:sup>31<\/jats:sup>\n                      P magnetic resonance spectroscopy and oxygenation-sensitive T2\u2032 magnetic resonance imaging were used (with 1\/T2\u2032=1\/T2*\u22121\/T2), which were expected to cross-validate each other.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>Ten patients with unilateral high-grade carotid artery stenosis resulting in a transient ischemic attack or a nondisabling cerebral ischemia were included. Then, high-energy metabolites, intracellular pH, and oxygenation-sensitive quantitative (q)T2\u2032 values were determined in noninfarcted hypoperfused areas delineated on time-to-peak maps from perfusion-weighted imaging and in unaffected contralateral areas before and shortly after carotid stenting\/endarterectomy. Repeated measures ANOVA was used to test for intervention effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>\n                      Within dependent hypoperfused areas ipsilateral to the stenosis, qT2\u2032 was significantly decreased (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05) as compared to corresponding contralateral areas before carotid intervention. There was a significant effect of carotid intervention on qT2\u2032 values in both hemispheres (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). No differences between hemispheres were found for qT2\u2032 after revascularization. Intracellular pH and qT2\u2032 values showed a significant negative relationship (\n                      <jats:italic>P<\/jats:italic>\n                      =0.005) irrespective of time point and hemisphere.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>After revascularization of unilateral high-grade carotid stenosis, previously decreased qT2\u2032 in the dependent hypoperfused territory as marker of hypoxia reincreases not only in the dependent territory but also in corresponding contralateral brain tissue. This might indicate a restriction of the whole-brain oxygen metabolism in case of unilateral high-grade carotid stenosis and an improvement of whole-brain oxygenation after revascularization that goes beyond acute clinically apparent affection of the dependent territory. Furthermore, tissue oxygen supply seems to be closely linked to intracellular pH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.118.023559","type":"journal-article","created":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T05:00:30Z","timestamp":1559710830000},"page":"1742-1750","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Revascularization of High-Grade Carotid Stenosis Restores Global Cerebral Energy Metabolism"],"prefix":"10.1161","volume":"50","author":[{"given":"Alexander","family":"Seiler","sequence":"first","affiliation":[{"name":"From the Department of Neurology (A.S., W.P.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Kammerer","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"G\u00fchl","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan R\u00fcdiger","family":"Sch\u00fcre","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Deichmann","sequence":"additional","affiliation":[{"name":"Brain Imaging Center (R.D., U.N.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"N\u00f6th","sequence":"additional","affiliation":[{"name":"Brain Imaging Center (R.D., U.N.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waltraud","family":"Pfeilschifter","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.S., W.P.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Hattingen","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Keese","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery (M.K.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Pilatus","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies","family":"Wagner","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology (S.K., A.G., J.R.S., E.H., U.P., M.W.), Goethe University Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.12.4.454"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410290302"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70185-X"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.61.1.18"},{"key":"e_1_3_3_6_2","first-page":"1992","article-title":"Significance of increased oxygen extraction fraction in five-year prognosis of major cerebral arterial occlusive diseases.","volume":"40","author":"Yamauchi H","year":"1999","unstructured":"Yamauchi, H, Fukuyama, H, Nagahama, Y, Nabatame, H, Ueno, M, Nishizawa, S, et al. 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