MRI lesion volume heterogeneity in primary progressive MS in relation with axonal damage and brain atrophy.
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.
Pelletier
D
D
Department of Neurology, University of California at San Francisco, San Francisco, CA, USA. danp@itsa.ucsf.edu
Nelson
S J
SJ
Oh
J
J
Antel
J P
JP
Kita
M
M
Zamvil
S S
SS
Goodkin
D E
DE
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
D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003404:Creatinine