Trajectories of brain lactate and re-visited oxygen-glucose index calculations do not support elevated non-oxidative metabolism of glucose across childhood

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  • Helene Benveniste
  • Gerald Dienel
  • Zvi Jacob
  • Hedok Lee
  • Rany Makaryus
  • Gjedde, Albert
  • Fahmeed Hyder
  • Douglas L. Rothman

Brain growth across childhood is a dynamic process associated with specific energy requirements. A disproportionately higher rate of glucose utilization (CMRglucose) compared with oxygen consumption (CMRO2) was documented in children's brain and suggestive of non-oxidative metabolism of glucose. Several candidate metabolic pathways may explain the CMRglucose-CMRO2 mismatch, and lactate production is considered a major contender. The ~33% excess CMRglucose equals 0.18 μmol glucose/g/min and predicts lactate release of 0.36 μmol/g/min. To validate such scenario, we measured the brain lactate concentration ([Lac]) in 65 children to determine if indeed lactate accumulates and is high enough to (1) account for the glucose consumed in excess of oxygen and (2) support a high rate of lactate efflux from the young brain. Across childhood, brain [Lac] was lower than predicted, and below the range for adult brain. In addition, we re-calculated the CMRglucose-CMRO2 mismatch itself by using updated lumped constant values. The calculated cerebral metabolic rate of lactate indicated a net influx of 0.04 μmol/g/min, or in terms of CMRglucose, of 0.02 μmol glucose/g/min. Accumulation of [Lac] and calculated efflux of lactate from brain are not consistent with the increase in non-oxidative metabolism of glucose. In addition, the value for the lumped constant for [18F]fluorodeoxyglucose has a high impact on calculated CMRglucose and use of updated values alters or eliminates the CMRglucose-CMRO2 mismatch in developing brain. We conclude that the presently-accepted notion of non-oxidative metabolism of glucose during childhood must be revisited and deserves further investigations.

Original languageEnglish
Article number631
JournalFrontiers in Neuroscience
Number of pages20
Publication statusPublished - 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Benveniste, Dienel, Jacob, Lee, Makaryus, Gjedde, Hyder and Rothman.

    Research areas

  • Aerobic glycolysis, Bioenergetics, Brain, Child, Development, Lactate, Non-oxidative metabolism

ID: 286485790