Research

Cortical N-acetyl aspartate is a predictor of long-term clinical disability in multiple sclerosis

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Abstract

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.

Primates Mammalia Vertebrata Chordata Animalia (Animals Chordates Humans Mammals Primates Vertebrates) - Hominidae [86215] 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