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

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...

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Published in:Neurological research (New York) 2014-08, Vol.36 (8), p.701-708
Main Authors: Wu, Xingchen, Hanson, Lars Grüner, Skimminge, Arnold, Sorensen, Per Soelberg, Paulson, Olaf Bjarne, Mathiesen, Henrik Kahr, Blinkenberg, Morten
Format: Article
Language:English
Subjects:
Adult
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Cerebral Cortex - metabolism
Cerebral Cortex - pathology
Cortical choline
Cortical NAA
Creatine - metabolism
Disability Evaluation
Disease Progression
Female
Humans
Magnetic Resonance Spectroscopy
Male
Middle Aged
MRI
MRSI
Multiple sclerosis
Multiple Sclerosis - diagnosis
Multiple Sclerosis - metabolism
Prognosis
Young Adult
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Summary: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.
ISSN:0161-6412
1743-1328
DOI:10.1179/1743132813Y.0000000312