title: Serial proton MR spectroscopy and diffusion tensor imaging in infantile Balo's concentric sclerosis.
abstract: BACKGROUND
  Proton magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) yield different parameters for characterizing the evolution of a demyelinating white matter disease. The purpose was to elucidate biochemical and microstructural changes in Balo's concentric sclerosis lesions and to correlate the findings with the clinical course.
  
  
  METHODS
  Localized short-echo time MRS and DTI were performed over 6 years in a left occipital lesion of a female patient (age at onset 13.8 years) with Balo's concentric sclerosis. A right homonym hemianopsia persisted.
  
  
  RESULTS
  Metabolite patterns were in line with initial active demyelination followed by gliosis and partial recovery of neuroaxonal metabolites. Fractional anisotropy and mean diffusivity of tissue water remained severely altered. Fiber tracking confirmed a disruption in the geniculo-calcarine tract as well as involvement of the corpus callosum.
  
  
  CONCLUSIONS
  MRS and DTI depict complementary parameters, but DTI seems to correlate better with clinical symptoms.
authors.affiliation: Department of Pediatrics and Pediatric Neurology, Georg August University, Göttingen, Germany. sdreha@gwdg.de
authors.forename: Steffi F
authors.initials: SF
authors.lastname: Dreha-Kulaczewski
authors.forename: Gunther
authors.initials: G
authors.lastname: Helms
authors.forename: Peter
authors.initials: P
authors.lastname: Dechent
authors.forename: Sabine
authors.initials: S
authors.lastname: Hofer
authors.forename: Jutta
authors.initials: J
authors.lastname: Gärtner
authors.forename: Jens
authors.initials: J
authors.lastname: Frahm
mesh_terms: D000293:Adolescent; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D011522:Protons; D014018:Tissue Distribution
chemical_list: D011522:Protons