title: MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study.
abstract: The purpose of this study was to correlate magnetic resonance imaging (MRI)-based lesion load assessment with clinical disability in early relapsing remitting multiple sclerosis (RRMS). Seventeen untreated patients (ten women, seven men; mean age 33.0 +/- 7.9 years) with the initial diagnosis of RRMS were included for cross-sectional as well as longitudinal (24 months) clinical and MRI-based assessment in comparison with age-matched healthy controls. Conventional MR sequences, MR spectroscopy (MRS) and magnetisation transfer imaging (MTI) were performed at 1.5 T. Lesion number and volume, MRS and MTI measurements for lesions and normal appearing white matter (NAWM) were correlated to clinical scores [Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC)] for monitoring disease course after treatment initiation (interferon beta-1a). MTI and MRS detected changes [magnetisation transfer ratio (MTR), N-acetylaspartate (NAA)/creatine ratio] in NAWM over time. EDSS and lesional MTR increases correlated throughout the disease course. Average MTR of NAWM raised during the study (p < 0.05) and correlated to the MSFC score (r = 0.476, p < 0.001). At study termination, NAA/creatine ratio of NAWM correlated to the MSFC score (p < 0.05). MTI and MRS were useful for initial disease assessment in NAWM. MTI and MRS correlated with clinical scores, indicating potential for monitoring the disease course and gaining new insights into treatment-related effects.
authors.affiliation: Cecilie Vogt Clinic for Neurology, Charité-University Medicine Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.forename: H
authors.initials: H
authors.lastname: Stiepani
authors.forename: J
authors.initials: J
authors.lastname: Wuerfel
authors.forename: G
authors.initials: G
authors.lastname: Bohner
authors.forename: F
authors.initials: F
authors.lastname: Paul
authors.forename: C
authors.initials: C
authors.lastname: Warmuth
authors.forename: O
authors.initials: O
authors.lastname: Aktas
authors.forename: K P
authors.initials: KP
authors.lastname: Wandinger
authors.forename: F
authors.initials: F
authors.lastname: Zipp
authors.forename: R
authors.initials: R
authors.lastname: Klingebiel
mesh_terms: D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula; D015415:Biomarkers / Q000032:analysis*; D001921:Brain / Q000378:metabolism / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000378:metabolism*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012008:Recurrence; D012075:Remission, Spontaneous; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers