title: Proton magnetic resonance spectroscopy in primary and secondary progressive multiple sclerosis.
abstract: The objective of this study was to characterize and compare the proton magnetic resonance spectrum of a voxel, containing lesions or normal-appearing white matter (NAWM), in primary-progressive (PP) and secondary-progressive (SP) multiple sclerosis (MS) patients. Single-voxel proton magnetic resonance spectroscopy and magnetic resonance imaging were performed in 35 MS patients (17 PP and 18 SP) and 17 controls. Spectra from an 8 ml voxel located in the parieto-occipital region were obtained with a spin-echo pulse sequence (1600 ms/135 ms/256, TR/TE/acquisitions). Resonance areas due to N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) and choline compounds (Cho) were determined, and results expressed in terms of area in arbitrary units or as metabolite ratios. With respect to the control group, there were significant reductions in NAA and NAA/Cho ratio in the PP-lesion, SP-lesion, PP-NAWM and SP-NAWM groups. There were no significant differences between the PP-NAWM and SP-NAWM groups. These results support the existence of metabolic changes in the white matter of PP and SP patients and suggest that there is neuronal damage and/or loss in both clinical courses. Finally, characterization of the parieto-occipital region showed no significant differences in the spectral pattern of NAWM between PP and SP clinical courses of MS.
authors.affiliation: Unitat de Ressonància Magnètica, Centre Vall d'Hebron, Institut de Diagnòstic per la Imatge, Pg. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
authors.forename: M G
authors.initials: MG
authors.lastname: Cucurella
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: J
authors.initials: J
authors.lastname: Río
authors.forename: S
authors.initials: S
authors.lastname: Pedraza
authors.forename: M M
authors.initials: MM
authors.lastname: Tintoré
authors.forename: X
authors.initials: X
authors.lastname: Montalbán
authors.forename: J
authors.initials: J
authors.lastname: Alonso
mesh_terms: D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D010725:Phosphocreatine / Q000378:metabolism
chemical_list: D010725:Phosphocreatine; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline