Brain, Vol. 117, No. 1, 49-58, 1994
© 1994 Oxford University Press
research-article |
Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions
NMR Research Group, Institute of Neurology Queen Square, London, UK
Correspondence to:
Correspondence to: Dr C. A. Davie, NMR Research Group, Institute of Neurology, Queen Square House, London WC1N 3BG, UK
Serial proton magnetic resonance spectroscopy (MRS), was carried out at 1–2 monthly intervals on eight patients with multiple sclerosis who presented with evidence of a large acute cerebral white matter lesion. An MRS was obtained from acute lesions (volumes of interest 4–12 ml), which at presentation showed gadolinium-diethylenetriamine penta-acetic acid enhancement, and from similar volumes of normal appearing white matter lateral to the lesion and nearer the scalp. Followup ranged from 4 to 9 months (mean 6 months). Short echo spectra from acute enhancing lesions invariably showed the presence of large resonances at 0.9 and 1.3 p.p.m. compared with normal appearing white matter and healthy age matched controls, indicating that these peaks were not the result of voxel contamination from scalp fat. These resonances, which probably represent lipid products of myelin breakdown, were detected in lesions which had been enhancing for < 1 month and remained elevated for a mean of 5 months (range 4–8 months). The results provide evidence that short echo proton MRS can detect myelin breakdown products and that myelin breakdown occurs during the initial inflammatory stage of lesion development. The ratio of N-acetylaspartate (NAA) (a neuronal marker) relative to creatine was reduced in acute lesions and in normal appearing white matter. In six of the lesions studied there was, however, a subsequent rise in the NAA/creatine ratio indicating that axonal loss is not the only mechanism of reduction in the NAA/creatine ratio.
NMR spectroscopy; multiple sclerosis; demyelination; lipids; N-acetylaspartate
Received August 12, 1993. Accepted November 5, 1993.
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P. H. M. F. van Domburg, M. A. A. P. Willemsen, J. J. Rotteveel, J. G. N. de Jong, H. O. M. Thijssen, A. Heerschap, J. R. M. Cruysberg, R. J. A. Wanders, F. J. M. Gabreels, and P. M. Steijlen Sjogren-Larsson syndrome: Clinical and MRI/MRS findings in FALDH-deficient patients Neurology, April 1, 1999; 52(7): 1345 - 1345. [Abstract] [Full Text] [PDF]
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S. D. Friedman, W. M. Brooks, R. E. Jung, S. J. Chiulli, J. H. Sloan, B. T. Montoya, B. L. Hart, and R. A. Yeo Quantitative proton MRS predicts outcome after traumatic brain injury Neurology, April 1, 1999; 52(7): 1384 - 1384. [Abstract] [Full Text]
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P. Sarchielli, O. Presciutti, G. P. Pelliccioli, R. Tarducci, G. Gobbi, P. Chiarini, A. Alberti, F. Vicinanza, and V. Gallai Absolute quantification of brain metabolites by proton magnetic resonance spectroscopy in normal-appearing white matter of multiple sclerosis patients Brain, March 1, 1999; 122(3): 513 - 521. [Abstract] [Full Text] [PDF]
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G Giovannoni, A J. Green, and E J Thompson Are there any body fluid markers of brain atrophy in multiple sclerosis? Multiple Sclerosis, June 1, 1998; 4(3): 138 - 142. [Abstract] [PDF]
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J N Lycke, J-E Karlsson, O Andersen, and L E Rosengren Neurofilament protein in cerebrospinal fluid: a potential marker of activity in multiple sclerosis J. Neurol. Neurosurg. Psychiatry, March 1, 1998; 64(3): 402 - 404. [Abstract] [Full Text] [PDF]
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P Sarchielli, O Presciutti, R Tarducci, G Gobbi, A Alberti, G P Pelliccioli, A Orlacchio, and V Gallai 1H-MRS in patients with multiple sclerosis undergoing treatment with interferon beta -1a: results of a preliminary study J. Neurol. Neurosurg. Psychiatry, February 1, 1998; 64(2): 204 - 212. [Abstract] [Full Text] [PDF]
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C A Davie, G J Barker, A J Thompson, P S Tofts, W I McDonald, and D H Miller 1H magnetic resonance spectroscopy of chronic cerebral white matter lesions and normal appearing white matter in multiple sclerosis J. Neurol. Neurosurg. Psychiatry, December 1, 1997; 63(6): 736 - 742. [Abstract] [Full Text] [PDF]
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W. M. Brooks, M. H. Wesley, P. W. Kodituwakku, P. J. Garry, and G. A. Rosenberg 1H-MRS Differentiates White Matter Hyperintensities in Subcortical Arteriosclerotic Encephalopathy From Those in Normal Elderly Stroke, October 1, 1997; 28(10): 1940 - 1943. [Abstract] [Full Text]
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A. Tourbah, J.-L. Stievenart, M.-T. Iba-Zizen, C. Lubetzki, N. Baumann, B. Eymard, H. W. Moser, O. Lyon-Caen, and E. A. Cabanis Localized Proton Magnetic Resonance Spectroscopy in Patients With Adult Adrenoleukodystrophy: Increase of Choline Compounds in Normal-Appearing White Matter Arch Neurol, May 1, 1997; 54(5): 586 - 592. [Abstract] [PDF]
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S. MacKay, D. J. Meyerhoff, J.-M. Constans, D. Norman, G. Fein, and M. W. Weiner Regional Gray and White Matter Metabolite Differences in Subjects With AD, With Subcortical Ischemic Vascular Dementia, and Elderly Controls With 1H Magnetic Resonance Spectroscopic Imaging Arch Neurol, February 1, 1996; 53(2): 167 - 174. [Abstract] [PDF]
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D. E. Saunders, F. A. Howe, A. van den Boogaart, M. A. McLean, J. R. Griffiths, and M. M. Brown Continuing Ischemic Damage After Acute Middle Cerebral Artery Infarction in Humans Demonstrated by Short-Echo Proton Spectroscopy Stroke, June 1, 1995; 26(6): 1007 - 1013. [Abstract] [Full Text]
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B. Movsas, B. S. Y. Li, J. S. Babb, B. L. Fowble, N. Nicolaou, and O. Gonen Quantifying Radiation Therapy-induced Brain Injury with Whole-Brain Proton MR Spectroscopy: Initial Observations Radiology, November 1, 2001; 221(2): 327 - 331. [Abstract] [Full Text] [PDF]
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