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MRI/MRS of corpus callosum in patients with clinically isolated syndrome suggestive of multiple sclerosis

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

J Pelletier

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France, Department of Neurology, Timone University Hospital of Marseille, France, jpelletier{at}mail.ap-hm.fr

S Confort-Gouny

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

D Ibarrola

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

B Audoin

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France, Department of Neurology, Timone University Hospital of Marseille, France

Y Le Fur

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

P Viout

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

A Ali Chérif

Department of Neurology, Timone University Hospital of Marseille, France

P J Cozzone

Centre de Résonance Magnétique Biologique et Médicale - UMR CNRS No. 6612, Medical School of Marseille, France

A trophy of corpus callosum (C C) related to axonal loss has previously been observed in patients at the early stage of clinically definite multiple sclerosis (CDMS). Atrophy increases with the progression of the disease. Nevertheless, no data concerning the onset of atrophy of C C are currently available. The purpose of this study is to determine if damage in callosal tissue was present at the earliest stage of MS, in a subgroup of patients presenting with a clinically isolated syndrome suggestive of MS (C ISSMS), fulfilling the dissemination in space criteria according to McDonald. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) techniques were applied to measure C C volume, magnetization transfer ratio (MTR), mean diffusivity (MD), N-acetyl aspartate/choline-containing compounds (NAA/C ho) ratio, N-acetyl aspartate/total creatine (NA A/C r) ratio and C ho/C r ratio inside the C C of 46 C ISSMS patients and 24 sexand age-matched controls. No atrophy of C C was observed in the C ISSMS group. C C of patients was character ized by decreased MTR and increased MD. No change in the NA A/C r ratio was observed while the NA A/C ho ratio decreased and C ho/C r ratio increased in the splenium and the central anterio r part of C C. These abnormalities were present in patients with, but also without, macroscopic lesions inside the C C. O ur results indicate that diffuse structural and metabolic changes, which may be interpreted as representing predominantly myelin patho logy, occur in the C C at the earliest stage of MS before any atrophy is detected.

Key Words: clinically iso lated syndrome suggestive of multiple sclerosis • diffusion-weighted and magnetization transfer-weighted MRI • magnetic resonance spectroscopic imaging

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