title: Imaging axonal damage in multiple sclerosis by means of MR spectroscopy.
abstract: Axonal damage in multiple sclerosis has become an important issue. This has been emphasized by recent in vivo proton magnetic resonance (MR) spectroscopy and in vitro pathology studies that have found axonal damage in both lesions and the surrounding normal-appearing white matter. In particular, proton MR spectroscopy, by monitoring levels of N-acetylaspartate (a putative marker of axonal integrity), has been particularly illuminating, as the extent of axonal injury associated with white matter inflammation and demyelination had not been well appreciated from classical pathology studies. Recent MR data demonstrate that cerebral axonal damage begins and contributes to disability from the earliest stages of the disease. This implies that the apparently primary role of axonal damage and loss in the pathogenesis of the disease should be given due importance, and argues for the early treatment of multiple sclerosis with agents directed not only against inflammation, but also towards axonal protection.
authors.affiliation: Neurometabolic Unit, Institute of Neurological Sciences, University of Siena, Italy.
authors.forename: N
authors.initials: N
authors.lastname: De Stefano
authors.forename: S
authors.initials: S
authors.lastname: Narayanan
authors.forename: M
authors.initials: M
authors.lastname: Mortilla
authors.forename: L
authors.initials: L
authors.lastname: Guidi
authors.forename: M L
authors.initials: ML
authors.lastname: Bartolozzi
authors.forename: A
authors.initials: A
authors.lastname: Federico
authors.forename: D L
authors.initials: DL
authors.lastname: Arnold
mesh_terms: D000818:Animals; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001369:Axons / Q000378:metabolism*; D002490:Central Nervous System / Q000378:metabolism*; D004185:Disability Evaluation; D018450:Disease Progression; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D009103:Multiple Sclerosis / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate