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J Physiol Volume 563, Number 1, 285-290, February 15, 2005 DOI: 10.1113/jphysiol.2004.075838
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Cerebral ammonia uptake and accumulation during prolonged exercise in humans

Lars Nybo1, Mads K Dalsgaard2, Adam Steensberg3, Kirsten Møller3 and Niels H Secher2

1 Department of Human Physiology, Institute of Exercise and Sport Sciences, and Departments of
2 Anaesthesia
3 Infectious Diseases, The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

We evaluated whether peripheral ammonia production during prolonged exercise enhances the uptake and subsequent accumulation of ammonia within the brain. Two studies determined the cerebral uptake of ammonia (arterial and jugular venous blood sampling combined with Kety–Schmidt-determined cerebral blood flow; n = 5) and the ammonia concentration in the cerebrospinal fluid (CSF; n = 8) at rest and immediately following prolonged exercise either with or without glucose supplementation. There was a net balance of ammonia across the brain at rest and at 30 min of exercise, whereas 3 h of exercise elicited an uptake of 3.7 ± 1.3 µmol min–1 (mean ± S.E.M.) in the placebo trial and 2.5 ± 1.0 µmol min–1 in the glucose trial (P < 0.05 compared to rest, not different across trials). At rest, CSF ammonia was below the detection limit of 2 µM in all subjects, but it increased to 5.3 ± 1.1 µM following exercise with glucose, and further to 16.1 ± 3.3 µM after the placebo trial (P < 0.05). Correlations were established between both the cerebral uptake (r2 = 0.87; P < 0.05) and the CSF concentration (r2 = 0.72; P < 0.05) and the arterial ammonia level and, in addition, a weaker correlation (r2 = 0.37; P < 0.05) was established between perceived exertion and CSF ammonia at the end of exercise. The results let us suggest that during prolonged exercise the cerebral uptake and accumulation of ammonia may provoke fatigue, e.g. by affecting neurotransmitter metabolism.

(Received 20 September 2004; accepted after revision 15 December 2004; first published online 20 December 2004)
Corresponding author L. Nybo: Department of Human Physiology, Institute of Exercise and Sport Sciences, August Krogh Institute, Universitetsparken 13, DK-2100 Copenhagen Ø, Denmark. Email: lnnielsen{at}aki.ku.dk




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