Brain energy metabolism

Abstract

All the processes described in this textbook require energy. Ample clinical evidence indicates that the brain is exquisitely sensitive to perturbations of energy metabolism. This chapter, adapted from Magistretti (2008), covers the topics of energy delivery, production, and utilization by the brain. Careful consideration of the basic mechanisms of brain energy metabolism is an essential prerequisite to a full understanding of the physiology and pathophysiology of brain function. Abnormalities in brain energy metabolism are observed in a variety of pathological conditions such as neurodegenerative diseases, stroke, epilepsy, and migraine. The chapter reviews the features of brain energy metabolism at the global, regional, and cellular levels and extensively describes recent advances in the understanding of neuroglial metabolic cooperation. A particular focus is the cellular and molecular mechanisms that tightly couple neuronal activity to energy consumption. This tight coupling is at the basis of functional brain-imaging techniques, such as positron emission tomography (PET) and functional magnetic resonance imaging.