title: MRI lesion volume heterogeneity in primary progressive MS in relation with axonal damage and brain atrophy.
abstract: OBJECTIVE
  To investigate whether axonal damage in primary progressive (PP) multiple sclerosis (MS), as measured by proton magnetic resonance spectroscopy (HMRS) imaging and brain atrophy, is a function of T2 weighted brain lesion volume.
  
  
  METHODS
  34 PP MS patients were divided into two categories: low (<3 cm(3), n = 18) or high (>or=3 cm(3), n = 16) T2 lesion load (LL). An Index of Brain Atrophy (IBA) was calculated and HMRS metabolite ratios were derived from a central brain area centred at the corpus callosum.
  
  
  RESULTS
  Patient groups did not differ with regard to clinical characteristics and showed lower mean IBA and mean N-acetylaspartate:creatinine (NAA:Cr) ratios compared to healthy controls.
  
  
  CONCLUSIONS
  PP patients with low and high brain T2LL have detectable brain atrophy and NAA:Cr reduction compared to healthy controls. In PP MS, T2 lesions alone are insufficient to explain the presence of brain atrophy and decrease in NAA:Cr.
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, CA, USA. danp@itsa.ucsf.edu
authors.forename: D
authors.initials: D
authors.lastname: Pelletier
authors.forename: S J
authors.initials: SJ
authors.lastname: Nelson
authors.forename: J
authors.initials: J
authors.lastname: Oh
authors.forename: J P
authors.initials: JP
authors.lastname: Antel
authors.forename: M
authors.initials: M
authors.lastname: Kita
authors.forename: S S
authors.initials: SS
authors.lastname: Zamvil
authors.forename: D E
authors.initials: DE
authors.lastname: Goodkin
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003404:Creatinine / Q000032:analysis; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis; D011522:Protons
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003404:Creatinine