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Metabolic differences between multiple sclerosis subtypes measured by quantitative MR spectroscopy

Department of Medicine, Brookhaven National Laboratory, State University of New York, Stony Brook, New York, USA, jpan{at}aecom.yu.edu

P K Coyle

Department of Neurology, State University of New York, Stony Brook, New York, USA

K Bashir

Department of Neurology, University of Alabama, Birmingham, Alabama, USA

J N Whitaker

Department of Neurology, University of Alabama, Birmingham, Alabama, USA

L B Krupp

Department of Neurology, State University of New York, Stony Brook, New York, USA

H P Hetherington

Department of Medicine, Brookhaven National Laboratory, State University of New York, Stony Brook, New York, USA

We used quantitative magnetic resonance (MR) spectroscopic imaging with T1-based image segmentation to evaluate the subtypes of multiple sclerosis (MS) (eight patients each group of relapsing-remitting [RR], secondary progressive [SP] and primary progressive [PP]). There was no significant difference in age between the PP group with the RR, SP or control group. We found that the metabolite ratio of choline/NA from the periventricular white matter region was not significantly different between the RR and SP groups. Using an ANOVA, the ratios of periventricular choline/NA or creatine/NA of these combined groups were significantly higher than the PP and control groups. Quantification of these data suggest that the major cause of the elevation of these parameters is due to an increase in choline and creatine in the RR group while NA is decreased in the SP group. Thus, early PP disease appears to be relatively intact with respect to neuronal loss.

Key Words: magnetic resonance spectroscopy • metabolism • multiple sclerosis • N-acetyl aspartate • primary progressive

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