Brain, Vol. 122, No. 3, 513-521,
March 1999
© 1999 Oxford University Press
Article |
Absolute quantification of brain metabolites by proton magnetic resonance spectroscopy in normal-appearing white matter of multiple sclerosis patients
1 Neurologic Clinic, University of Perugia, 2 Department of Medical Physics and 3 Department of Neuroradiology, Azienda Ospedaliera di Perugia, Italy
Correspondence to:
Paola Sarchielli, Neurologic Clinic, Policlinico Monteluce, Via E. Dal Pozzo 06126 Perugia, Italy E-mail: neuro{at}netemedia.net
The aim of this research was to obtain an absolute quantification of the N-acetyl-aspartate, choline, creatine and phosphocreatine levels in normal-appearing white matter by means of 1H magnetic resonance spectroscopy in a group of multiple sclerosis patients (27 with the relapsing–remitting form and 13 with the secondary progressive form). These values were compared with those of a group of 12 age-matched healthy control subjects. A significant decrease in the N-acetyl-aspartate concentration was found in normal-appearing white matter of frontal and parietal brain areas in multiple sclerosis patients compared with the same areas in control subjects. This reduction was more evident in progressive patients. The decrease in the N-acetyl-aspartate concentration in normal-appearing white matter significantly correlated with the Expanded Disability Status and the lesional load. No significant change was found in the concentration of creatine or choline. This finding concurs with previous evidence of heterogeneity in the multiple sclerosis pathological process which is not confined to the lesions and involves not only myelin, but also axons, even in white matter which appears normal on MRI.
proton magnetic resonance spectroscopy; normal-appearing white matter; multiple sclerosis; N-acetyl-aspartate; creatine; choline
ANOVA = analysis of variance; Ch = choline ; Cr = creatine + phosphocreatine; EDSS = Expanded disability status scale; FOV = field of view; In = inositol; 1H-MRS = proton magnetic resonance spectroscopy; NAA = N-acetyl-aspartate; TE = echo time; TR = repetition time; VOI = volume of interest
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Bichuetti, E. Oliveira, N. Souza, R. Rivero, and A. Gabbai Neuromyelitis optica in Brazil: a study on clinical and prognostic factors Multiple Sclerosis, May 1, 2009; 15(5): 613 - 619. [Abstract] [PDF]
|
|
|
|
 |
|
 N. De Stefano, M. Filippi, D. Miller, P. J. Pouwels, A. Rovira, A. Gass, C. Enzinger, P. M. Matthews, and D. L. Arnold Guidelines for using proton MR spectroscopy in multicenter clinical MS studies Neurology, November 13, 2007; 69(20): 1942 - 1952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.C. Gustafsson, O. Dahlqvist, J. Jaworski, P. Lundberg, and A.-M.E. Landtblom Low Choline Concentrations in Normal-Appearing White Matter of Patients with Multiple Sclerosis and Normal MR Imaging Brain Scans AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1306 - 1312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Sirrs, C. Laule, B. Madler, E. E. Brief, S. A. Tahir, C. Bishop, and A. L. MacKay Normal-appearing White Matter in Patients with Phenylketonuria: Water Content, Myelin Water Fraction, and Metabolite Concentrations Radiology, January 1, 2007; 242(1): 236 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kutzelnigg, C. F. Lucchinetti, C. Stadelmann, W. Bruck, H. Rauschka, M. Bergmann, M. Schmidbauer, J. E. Parisi, and H. Lassmann Cortical demyelination and diffuse white matter injury in multiple sclerosis Brain, November 1, 2005; 128(11): 2705 - 2712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Caramanos, S. Narayanan, and D. L. Arnold 1H-MRS quantification of tNA and tCr in patients with multiple sclerosis: a meta-analytic review Brain, November 1, 2005; 128(11): 2483 - 2506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Krapf, S. P. Morrissey, O. Zenker, T. Zwingers, R. Gonsette, H. -P. Hartung, and the MIMS Study Group Effect of mitoxantrone on MRI in progressive MS: Results of the MIMS trial Neurology, September 13, 2005; 65(5): 690 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Staffen, H. Zauner, A. Mair, A. Kutzelnigg, P. Kapeller, H. Stangl, E. Raffer, H. Niederhofer, and G. Ladurner Magnetic Resonance Spectroscopy of Memory and Frontal Brain Region in Early Multiple Sclerosis J Neuropsychiatry Clin Neurosci, August 1, 2005; 17(3): 357 - 363. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Srinivasan, N. Sailasuta, R. Hurd, S. Nelson, and D. Pelletier Evidence of elevated glutamate in multiple sclerosis using magnetic resonance spectroscopy at 3 T Brain, May 1, 2005; 128(5): 1016 - 1025. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Sastre-Garriga, G. T. Ingle, D. T. Chard, Li. Ramio-Torrenta, M. A. McLean, D. H. Miller, and A. J. Thompson Metabolite Changes in Normal-Appearing Gray and White Matter Are Linked With Disability in Early Primary Progressive Multiple Sclerosis Arch Neurol, April 1, 2005; 62(4): 569 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. He, M. Inglese, B. S. Y. Li, J. S. Babb, R. I. Grossman, and O. Gonen Relapsing-Remitting Multiple Sclerosis: Metabolic Abnormality in Nonenhancing Lesions and Normal-appearing White Matter at MR Imaging: Initial Experience Radiology, January 1, 2005; 234(1): 211 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Oh, D. Pelletier, and S. J. Nelson Corpus Callosum Axonal Injury in Multiple Sclerosis Measured by Proton Magnetic Resonance Spectroscopic Imaging Arch Neurol, July 1, 2004; 61(7): 1081 - 1086. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. M. Fernando, M. A. McLean, D. T. Chard, D. G. MacManus, C. M. Dalton, K. A. Miszkiel, R. M. Gordon, G. T. Plant, A. J. Thompson, and D. H. Miller Elevated white matter myo-inositol in clinically isolated syndromes suggestive of multiple sclerosis Brain, June 1, 2004; 127(6): 1361 - 1369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Schmierer, D. R Altmann, N. Kassim, H. Kitzler, C. M Kerskens, C. A Doege, O. Aktas, J. D Lunemann, D. H Miller, F. Zipp, et al. Progressive change in primary progressive multiple sclerosis normal-appearing white matter: a serial diffusion magnetic resonance imaging study Multiple Sclerosis, April 1, 2004; 10(2): 182 - 187. [Abstract] [PDF]
|
|
|
|
|
|
M. C. Tartaglia, S. Narayanan, S. J. Francis, A. C. Santos, N. De Stefano, Y. Lapierre, and D. L. Arnold The Relationship Between Diffuse Axonal Damage and Fatigue in Multiple Sclerosis Arch Neurol, February 1, 2004; 61(2): 201 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J P Ranjeva, J Pelletier, S Confort-Gouny, D Ibarrola, B Audoin, Y Le Fur, P Viout, A A. Cherif, and P J Cozzone MRI/MRS of corpus callosum in patients with clinically isolated syndrome suggestive of multiple sclerosis Multiple Sclerosis, December 1, 2003; 9(6): 554 - 565. [Abstract] [PDF]
|
|
|
|
|
|
P. Sarchielli, L. Greco, A. Floridi, A. Floridi, and V. Gallai Excitatory Amino Acids and Multiple Sclerosis: Evidence From Cerebrospinal Fluid Arch Neurol, August 1, 2003; 60(8): 1082 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Pelletier, S J Nelson, J Oh, J P Antel, M Kita, S S Zamvil, and D E Goodkin MRI lesion volume heterogeneity in primary progressive MS in relation with axonal damage and brain atrophy J. Neurol. Neurosurg. Psychiatry, July 1, 2003; 74(7): 950 - 952. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Christodoulou, L. B. Krupp, Z. Liang, W. Huang, P. Melville, C. Roque, W. F. Scherl, T. Morgan, W. S. MacAllister, L. Li, et al. Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients Neurology, June 10, 2003; 60(11): 1793 - 1798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Reddy, S. Narayanan, M. Woolrich, T. Mitsumori, Y. Lapierre, D. L. Arnold, and P. M. Matthews Functional brain reorganization for hand movement in patients with multiple sclerosis: defining distinct effects of injury and disability Brain, December 1, 2002; 125(12): 2646 - 2657. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. McFarland, F. Barkhof, J. Antel, and D. Miller The role of MRI as a surrogate outcome measure in multiple sclerosis Multiple Sclerosis, September 1, 2002; 8(1_suppl): 40 - 51. [Abstract] [PDF]
|
|
|
|
|
|
H F McFarland, F Barkhof, J Antel, and D H Miller The role of MRI as a surrogate outcome measure in multiple sclerosis Multiple Sclerosis, February 1, 2002; 8(1): 40 - 51. [Abstract] [PDF]
|
|
|
|
 |
|
 H. Reddy, N. De Stefano, M. Mortilla, A. Federico, and P. M. Matthews Functional Reorganization of Motor Cortex Increases With Greater Axonal Injury From CADASIL Stroke, February 1, 2002; 33(2): 502 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Griffin, D. T Chard, O. Ciccarelli, R. Kapoor, G. J Barker, A. J Thompson, and D. H Miller Diffusion tensor imaging in early relapsing-remitting multiple sclerosis Multiple Sclerosis, October 1, 2001; 7(5): 290 - 297. [Abstract] [PDF]
|
|
|
|
|
|
I. Mader, U. Seeger, R. Weissert, U. Klose, T. Naegele, A. Melms, and W. Grodd Proton MR spectroscopy with metabolite-nulling reveals elevated macromolecules in acute multiple sclerosis Brain, May 1, 2001; 124(5): 953 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Ciccarelli, D.J. Werring, C.A.M. Wheeler-Kingshott, G.J. Barker, G.J.M. Parker, A.J. Thompson, and D.H. Miller Investigation of MS normal-appearing brain using diffusion tensor MRI with clinical correlations Neurology, April 10, 2001; 56(7): 926 - 933. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D J Werring, C A Clark, A G Droogan, G J Barker, D H Miller, and A J Thompson Water diffusion is elevated in widespread regions of normal-appearing white matter in multiple sclerosis and correlates with diffusion in focal lesions Multiple Sclerosis, April 1, 2001; 7(2): 83 - 89. [Abstract] [PDF]
|
|
|
|
|
|
N. De Stefano, M. T. Dotti, M. Mortilla, and A. Federico Magnetic resonance imaging and spectroscopic changes in brains of patients with cerebrotendinous xanthomatosis Brain, January 1, 2001; 124(1): 121 - 131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. De Stefano, S. Narayanan, G. S. Francis, R. Arnaoutelis, M. C. Tartaglia, J. P. Antel, P. M. Matthews, and D. L. Arnold Evidence of Axonal Damage in the Early Stages of Multiple Sclerosis and Its Relevance to Disability Arch Neurol, January 1, 2001; 58(1): 65 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Pelletier, L. Suchet, T. Witjas, M. Habib, C. R. G. Guttmann, G. Salamon, O. Lyon-Caen, and A. A. Cherif A Longitudinal Study of Callosal Atrophy and Interhemispheric Dysfunction in Relapsing-Remitting Multiple Sclerosis Arch Neurol, January 1, 2001; 58(1): 105 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Reddy, S. Narayanan, R. Arnoutelis, M. Jenkinson, J. Antel, P. M. Matthews, and D. L. Arnold Evidence for adaptive functional changes in the cerebral cortex with axonal injury from multiple sclerosis Brain, November 1, 2000; 123(11): 2314 - 2320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Suhy, W D Rooney, D E Goodkin, A A Capizzano, B J Soher, A A Maudsley, E Waubant, P B Andersson, and M W Weiner 1H MRSI comparison of white matter and lesions in primary progressive and relapsing-remitting MS Multiple Sclerosis, June 1, 2000; 6(3): 148 - 155. [Abstract] [PDF]
|
|
|
|
|
|
H. Reddy, S. Narayanan, P. M. Matthews, R. D. Hoge, G. B. Pike, P. Duquette, J. Antel, and D. L. Arnold Relating axonal injury to functional recovery in MS Neurology, January 11, 2000; 54(1): 236 - 236. [Abstract] [Full Text] [PDF]
|
|