Relapsing-remitting multiple sclerosis and whole-brain N-acetylaspartate measurement:: Evidence for different clinical cohorts -: Initial observations

被引:22
作者
Gonen, O
Moriarty, DM
Li, BSY
Babb, JS
He, J
Listerud, J
Jacobs, D
Markowitz, CE
Grossman, RI
机构
[1] NYU, Sch Med, Dept Radiol, New York, NY 10012 USA
[2] Univ Penn, Ctr Med, Dept Neurol, Philadelphia, PA 19104 USA
关键词
magnetic resonance (MR); spectroscopy; sclerosis; multiple;
D O I
10.1148/radiol.2243011260
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To quantify the rate of concentration decline of neuronal marker N-acetylaspartate (NAA) in the entire brain of patients with relapsing-remitting multiple sclerosis (MS) in relation to healthy age-matched control subjects. MATERIALS AND METHODS: Whole-brain NAA (WBNAA) concentration was quantified in 49 patients with relapsing-remitting MS by using magnetic resonance (MR) imaging and proton MR spectroscopy. It was statistically analyzed by using Spearman rank correlation coefficients to test the intragroup relationship between WBNAA and Expanded Disability Status Scale (EDSS) score and Mann-Whitney analyses to test for differences between subgroups' EDSS scores versus previously published WBNAA values for healthy subjects, disease duration, and age. RESULTS: Analyses indicated three subgroups of WBNAA dynamics: Ten patients' conditions were "stable," exhibiting an insignificant change of about 0% (0.02/14.37) per year of clinically definite disease duration (P = .54); 27 patients showed "moderate" decline, -2.8% (-0.34/12.18) per year (P < .01); and 12 patients experienced "rapid" decline, -27.9% (-3.39/12.14) per year (P < .01). No correlation was found between WBNAA deficit, EDSS score, and age. CONCLUSION: Ascertaining an individual's NAA concentration dynamics might enable early forecast of disease course, reflect disease severity and thus influence treatment decisions, and improve clinical trial efficiency by allowing selection of candidates on the basis of WBNAA dynamics in addition to clinical status. (C) RSNA, 2002.
引用
收藏
页码:261 / 268
页数:8
相关论文
共 46 条
[1]   Progressive cerebral atrophy in MS: A serial study using registered, volumetric MRI [J].
Adams, HP ;
Koziol, JA .
NEUROLOGY, 2000, 55 (08) :1242-1243
[2]   USE OF PROTON MAGNETIC-RESONANCE SPECTROSCOPY FOR MONITORING DISEASE PROGRESSION IN MULTIPLE-SCLEROSIS [J].
ARNOLD, DL ;
RIESS, GT ;
MATTHEWS, PM ;
FRANCIS, GS ;
COLLINS, DL ;
WOLFSON, C ;
ANTEL, JP .
ANNALS OF NEUROLOGY, 1994, 36 (01) :76-82
[3]  
Bjartmar C, 2000, ANN NEUROL, V48, P893, DOI 10.1002/1531-8249(200012)48:6<893::AID-ANA10>3.3.CO
[4]  
2-2
[5]   N-acetyl aspartate:: A marker for neuronal loss or mitochondrial dysfunction [J].
Clark, JB .
DEVELOPMENTAL NEUROSCIENCE, 1998, 20 (4-5) :271-276
[6]   Effect of early interferon treatment on conversion to definite multiple sclerosis:: a randomised study [J].
Comi, G ;
Filippi, M ;
Barkhof, F ;
Durelli, L ;
Edan, G ;
Fernández, O ;
Hartung, HP ;
Seeldrayers, P ;
Sorensen, PS ;
Rovaris, M ;
Martinelli, V ;
Hommes, OR .
LANCET, 2001, 357 (9268) :1576-1582
[7]   SERIAL PROTON MAGNETIC-RESONANCE SPECTROSCOPY IN ACUTE MULTIPLE-SCLEROSIS LESIONS [J].
DAVIE, CA ;
HAWKINS, CP ;
BARKER, GJ ;
BRENNAN, A ;
TOFTS, PS ;
MILLER, DH ;
MCDONALD, WI .
BRAIN, 1994, 117 :49-58
[8]   Axonal damage correlates with disability in patients with relapsing-remitting multiple sclerosis - Results of a longitudinal magnetic resonance spectroscopy study [J].
De Stefano, N ;
Matthews, PM ;
Fu, LQ ;
Narayanan, S ;
Stanley, J ;
Francis, GS ;
Antel, JP ;
Arnold, DL .
BRAIN, 1998, 121 :1469-1477
[9]   Imaging axonal damage in multiple sclerosis by means of MR spectroscopy [J].
N. De Stefano ;
S. Narayanan ;
M. Mortilla ;
L. Guidi ;
M.L. Bartolozzi ;
A. Federico ;
D.L. Arnold .
Neurological Sciences, 2000, 21 (Suppl 2) :S883-S887
[10]   In vivo evidence for axonal dysfunction remote from focal cerebral demyelination of the type seen in multiple sclerosis [J].
De Stefano, N ;
Narayanan, S ;
Matthews, PM ;
Francis, GS ;
Antel, JP ;
Arnold, DL .
BRAIN, 1999, 122 :1933-1939