Wu, Xingchen3; Hanson, Lars G.4; Skimminge, Arnold Jesper Møller3; Sorensen, Per Soelberg3; Paulson, Olaf Bjarne3; Mathiesen, Henrik Kahr3; Blinkenberg, Morten3
1 Department of Electrical Engineering, Technical University of Denmark2 Biomedical Engineering, Department of Electrical Engineering, Technical University of Denmark3 University of Copenhagen4 Copenhagen Center for Health Technology, Center, Technical University of Denmark
Objective: To evaluate the prognostic value of the cortical N-acetyl aspartate to creatine ratio (NAA/Cr) in early relapsing-remitting multiple sclerosis (RRMS). Methods: Sixteen patients with newly diagnosed RRMS were studied by serial MRI and MR spectroscopic imaging (MRSI) once every 6 months for 24 months. Clinical examinations, including the expanded disability status scale (EDSS), were performed at baseline, month 24, and at year 7. Results: Baseline cortical NAA/Cr correlated inversely with EDSS at month 24 (r = -0.61, P <0.05), and patients with EDSS >= 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P <0.05). Baseline cortical NAA/Cr also correlated inversely with EDSS at the 7-year follow-up (r = -0.56, P <0.05), and patients with EDSS >= 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P <0.05). Baseline brain parenchymal fraction (BPF) correlated inversely with EDSS at month 24 (r = -0.61, P <0.05), but not with EDSS at year 7. Discussion: Cortical NAA/Cr in early RRMS correlated with clinical disability after 2 and 7 years and may be used as a predictor of long-term disease outcome.
Neurological Research, 2014, Vol 36, Issue 8, p. 701-708
Adult; Aspartic Acid; Cerebral Cortex; Creatine; Disability Evaluation; Disease Progression; Female; Humans; Magnetic Resonance Spectroscopy; Male; Middle Aged; Multiple Sclerosis; Prognosis; Young Adult; Primates Mammalia Vertebrata Chordata Animalia (Animals, Chordates, Humans, Mammals, Primates, Vertebrates) - Hominidae  human common adult female, male; creatine 57-00-1; N-acetyl aspartate 997-55-7; 06504, Radiation biology - Radiation and isotope techniques; 10064, Biochemistry studies - Proteins, peptides and amino acids; 20504, Nervous system - Physiology and biochemistry; 20506, Nervous system - Pathology; 34508, Immunology - Immunopathology, tissue immunology; Clinical Immunology; Neurology; Radiology; relapsing-remitting multiple sclerosis Multiple Sclerosis, Relapsing-Remitting (MeSH) nervous system disease, immune system disease; clinical disability; Human Medicine, Medical Sciences; Medical Sciences; brain nervous system; clinical examination clinical techniques, diagnostic techniques; magnetic resonance imaging imaging and microscopy techniques, diagnostic techniques, clinical techniques; magnetic resonance spectroscopy laboratory techniques, spectrum analysis techniques; CLINICAL; NEUROSCIENCES; APPEARING WHITE-MATTER; MAGNETIC-RESONANCE-SPECTROSCOPY; AXONAL DAMAGE; GRAY-MATTER; METABOLITE CHANGES; GREY-MATTER; BRAIN; LESIONS; IMPAIRMENT; RELEVANCE; MRSI; MRI; Cortical NAA; Cortical choline; Multiple sclerosis