Metabolic changes in normal-appearing white matter in patients with neuromyelitis optica and multiple sclerosis: a comparative magnetic resonance spectroscopy study

2017 ◽  
Vol 58 (9) ◽  
pp. 1132-1137 ◽  
Author(s):  
Yunyun Duan ◽  
Zheng Liu ◽  
Yaou Liu ◽  
Jing Huang ◽  
Zhuoqiong Ren ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Neuronal Damage ◽  
Small Sample ◽  
Metabolic Changes ◽  
Resonance Spectroscopy ◽  
Normal Appearing White Matter ◽  
The Absolute

Background Previous studies with a small sample size have not reported metabolic changes in neuromyelitis optica (NMO). Metabolic changes, such as decreased N-acetylaspartate (NAA), are well-established in patients with multiple sclerosis (MS). It remains unknown whether different patterns of metabolic changes occur in NMO and MS. Purpose To investigate the metabolic changes in normal-appearing white matter (NAWM) in NMO, compared with MS patients and healthy controls (HC), and correlate these changes with clinical disability. Material and Methods We recruited 27 patients with NMO, 24 patients with MS, and 24 HC. Each participant underwent chemical shift imaging with a 1H-MR spectroscopy operating in a 1.5 T magnetic resonance imaging (MRI) scanner. The absolute concentrations of NAA, choline (Cho), creatine (Cr) as well as the metabolite ratios of NAA/Cr, Cho/Cr, and NAA/Cho were measured and compared among the groups. The correlations between the metabolic concentrations, disease duration, and clinical disability (Expanded Disability Status Scale, EDSS) were further explored. Results Compared with HC, a mild increase of Cho without significant NAA changes was observed in NMO patients, while both a significant reduction of NAA and an increase of Cho were observed in MS patients. The absolute concentration of NAA and NAA/Cho ratio were significantly decreased in MS patients in a direct comparison with NMO patients. In MS patients, the EDSS was correlated with the NAA/Cr and Cho/Cr ratios. Conclusion A reduction of NAA was not observed in NMO, implying axonal or neuronal damage may be absent in NAWM for NMO, which is different from MS. A mild increase in Cho was observed in NAWM of NMO patients, suggesting that subtle metabolic changes occur in NMO.

scholarly journals An optimal 1H-MRS technique at 7T: Proof-of-principle in Chronic Multiple Sclerosis and Neuromyelitis Optica Brain Lesions and Normal Appearing Brain Tissue.

2020 ◽  
Author(s):  
George Tackley ◽  
Yazhuo Kong ◽  
Rachel Minne ◽  
Silvia Messina ◽  
Anderson Winkler ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Neuromyelitis Optica ◽  
A Priori ◽  
Brain Lesions ◽  
Resonance Spectroscopy ◽  
1H Mrs ◽  
Normal Appearing White Matter ◽  
Brain White Matter ◽  
Post Hoc

Magnetic Resonance Spectroscopy (MRS) allows for the non-invasive quantification of neurochemicals and has the potential to differentiate between the pathologically distinct diseases, multiple sclerosis (MS) and AQP4Ab-positive neuromyelitis optica spectrum disorder (AQP4Ab-NMOSD). In this study we characterised the metabolite profiles of brain lesions in 11 MS and 4 AQP4Ab-NMOSD patients using an optimised MRS methodology at ultra-high field strength (7T) incorporating correction for T2 water relaxation differences between lesioned and normal tissue. MS metabolite results were in keeping with the existing literature: total NAA was lower in lesions compared to normal appearing brain white matter (NAWM) with reciprocal findings for Inositol. An unexpected subtlety revealed by our technique was that total NAA differences were driven by NAA-glutamate (NAAG), a ubiquitous CNS molecule with functions quite distinct from NAA though commonly quantified together with NAA in MRS studies as total NAA. Surprisingly, AQP4Ab-NMOSD showed no significant differences for total NAA, NAA, NAAG or Inositol between lesion and NAWM sites, nor were there any differences between MS and AQP4Ab-NMOSD for a priori hypotheses. Post-hoc testing did however reveal greater total NAA in MS compared to AQP4Ab-NMOSD NAWM. Post-hoc testing also revealed a significant correlation between NAWM Ins:NAA and disability (as measured by EDSS) for disease groups combined, driven by the AP4Ab-NMOSD group. Utilising an optimised MRS methodology, our study highlights some under-explored subtleties in MRS profiles, such as the absence of Inositol concentration differences in AQP4Ab-NMOSD brain lesions versus NAWM and the important influence of NAAG differences between lesions and normal appearing white matter in MS.

1H MRSI of normal appearing white matter in multiple sclerosis

1997 ◽  
Vol 3 (4) ◽  
pp. 231-237 ◽  
Author(s):  
WD Rooney ◽  
DE Goodkin ◽  
N. Schuff ◽  
DJ Meyerhoff ◽  
D. Norman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Proton Magnetic Resonance ◽  
Brain Lesion ◽  
Resonance Spectroscopy ◽  
Lesion Volume ◽  
Neuronal Marker ◽  
Control Subjects ◽  
Normal Appearing White Matter

The primary goal of this study was to determine if differences in proton magnetic resonance spectroscopy signals exist between normal appearing white matter (NAWM) of multiple sclerosis (MS) patients and white matter of control subjects. Water suppressed proton magnetic resonance spectroscopic imaging was used to determine the signal intensities of N-acetylated moieties (NA, predominantly N-acetylaspartate (NAA) the putative neuronal marker), creatine and phosphocreatine (Cr), and cholines (Ch) in 19 MS patients (15 relapsing-remitting and four secondary progressive) and 19 age matched control subjects. NA/Cr was significantly reduced (P < 0.00 1) in MS NAWM (1.8 ± 0.2; x ± s.d.) distant from MRI detected lesion areas compared to white matter of control subjects (2.1 ± 0.2). This reduction was due to an increase in Cr from 0.39 ± 0.04 (arbitrary units) in controls to 0.45 ± 0.05 in MS patients. There was no significant change in NA or Ch in MS NAWM compared to controls. NA/ Cr, distant from MRI lesion, was negatively correlated with total brain lesion volume as measured from T2-weighted MRI. We interpret the reduced NA/Cr in MS NAWM to indicate diffuse microscopic disease.

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