MR spectroscopic evidence for thalamic and hippocampal, but not cortical, damage in multiple sclerosis

✍ Scribed by Jeroen J. G. Geurts; Ilona E. W. Reuling; Hugo Vrenken; Bernard M. J. Uitdehaag; Chris H. Polman; Jonas A. Castelijns; Frederik Barkhof; Petra J. W. Pouwels

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 385 KB
• Volume: 55
• Category: Article
• ISSN: 0740-3194
• DOI: 10.1002/mrm.20792

✦ Synopsis

Abstract

Gray matter (GM) damage is an important pathophysiological feature in Multiple Sclerosis (MS), and may be related to clinical, including cognitive, deficits. Quantitative single‐voxel ^1^H‐Magnetic Resonance Spectroscopy (TR/TE 6000/20 ms) was performed in 33 MS patients (11 per disease subtype; mean age 48 years, 16 females) and 10 healthy controls (mean age 43 years, 7 females). No overall spectroscopic changes were found in MS cortex. In MS thalamus, a 9% decrease of N‐acetyl aspartate (NAA; P = 0.005) and a 31% increase of myo‐inositol (Ins; P = 0.002) were found. A 21% Ins increase was observed (P = 0.02) in MS hippocampus. Reduced NAA and increased Ins concentrations are thought to reflect neuro‐axonal damage or loss and gliosis, respectively. Significant correlations between Ins concentrations and total‐brain T~2~ lesion load were found for MS thalamus (r = 0.65, P < 0.001) and hippocampus (r = 0.57, P = 0.001). MS thalamic and hippocampal Ins concentrations also correlated with each other (r = 0.68; P < 0.001). Cortical Gln correlated with thalamic NAA (r = −0.38; P = 0.03) in MS. Thalamic and hippocampal Ins increases were most prominent in secondary‐progressive (SP) patients (37% and 34%, respectively), whereas the largest thalamic NAA decrease (14%) was found in primary‐progressive (PP) patients. In conclusion, thalamic and hippocampal GM pathology are important features of (progressive) MS. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.