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Figure 1.

Schematic diagram of experimental protocol.

Counterregulatory hormone levels, hypoglycemic symptom scores and rCBF measurements were obtained during the hyperinsulinemic euglycemic – hypoglycemic clamp. rCBF measurements were obtained using PASL-MRI and [15O]water PET for healthy individuals (n = 9).

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Figure 1 Expand

Figure 2.

Free Surfer regions of interest.

Free Surfer maps of ROI used for this analysis. A) Sagittal (top) B) Axial (bottom) view of Freesurfer ROIs. Blue: globus pallidum, Green: caudate, Dark Green: lateral prefrontal cortex, Magenta: medial prefrontal cortex.

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Figure 2 Expand

Table 1.

Mean (±SE) plasma glucose and counterregulatory hormones at baseline and at time of CBF acquisition for euglycemic and hypoglycemic clamp phases and peak levels during each phase.

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Figure 3.

Qualitative cerebral blood flow during hypoglycemia and euglycemia in PET and PASL-MRI.

Axial images showing the mean difference (CBF hypoglycemia – CBF euglycemia) maps from nine subjects for A) positron emission tomography (PET) and B) pulse arterial spin labeling magnetic resonance imaging (PASL-MRI). Yellow/orange represents increased and blue represents decreased blood flow during the hypoglycemic relative to euglycemic session. Similar increases in CBF for hypoglycemia were seen for both methods within the thalamus.

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Figure 4.

Quantitative regional cerebral blood flow during euglycemia and hypoglycemia in PET and PASL-MRI.

Quantitative regional CBF (mL.100 g−1. min−1) responses for euglycemia (black bars) and hypoglycemia (white bars) within a previously identified network. Significant increases in CBF were seen with hypoglycemia within the thalamus (THAL), globus pallidum (GP), and medial prefrontal cortex (MPF) for both A) PET and B) PASL-MRI. No significant increases were seen in the right orbitoprefrontal cortex (ROPF). *p<0.05.

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