title: The Relationship Between Brain MR Spectroscopy and Disability in Multiple Sclerosis: 20-Year Data from the U.S. Glatiramer Acetate Extension Study.
abstract: Conventional MRI techniques do not necessarily provide information about multiple sclerosis (MS) disease pathology or progression. Nonconventional MRI techniques, including proton magnetic resonance spectroscopy (1H-MRS), are increasingly used to improve the qualitative and quantitative specificity of MR images. This study explores potential correlations between MRI measures of disease and disability progression as measured by the Expanded Disability Status Scale (EDSS), Functional Systems (FS), and ambulation index scores in a unique cohort of MS patients treated with glatiramer acetate that has been closely monitored for over 20 years.
  
  
  
  This was a multicenter, open-label, cross-sectional MRI substudy among participants in the GA-9004 open-label extension of the 36-month, double-blind GA-9001 study, timed to coincide with the prospectively planned 20-year clinical exam.
  
  
  
  Of 64 patients who participated in the MRI substudy, results are presented for the 39 patients (61%) who had a1H-MRS assessment at 20 years of treatment. Both total N-acetylaspartate relative to total creatinine (tNAA/tCr) concentration ratio and T1 lesion volume were found to be robustly associated with disability levels with different statistical approaches. Gray matter (GM) volume was found to be a more consistent parameter than white matter (WM) volume for disability allocation. The elastic net algorithm showed a trade-off between WM and GM volumes for disability estimation when different disability definitions were used.
  
  
  
  Among patients with MS receiving long-term glatiramer acetate therapy, consistent effects on disability levels indicated by EDSS and pyramidal FS score thresholds were found for tNAA/tCr concentration ratio and T1 lesion volume.
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.|The Sastry Foundation Advanced Imaging Laboratory, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Omar
authors.initials: O
authors.lastname: Khan
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Navid
authors.initials: N
authors.lastname: Seraji-Bozorgzad
authors.affiliation: The Sastry Foundation Advanced Imaging Laboratory, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Fen
authors.initials: F
authors.lastname: Bao
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Sara
authors.initials: S
authors.lastname: Razmjou
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Christina
authors.initials: C
authors.lastname: Caon
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Carla
authors.initials: C
authors.lastname: Santiago
authors.affiliation: Department of Diagnostic Radiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Latif
authors.affiliation: Department of Diagnostic Radiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Rimma
authors.initials: R
authors.lastname: Aronov
authors.affiliation: Department of Diagnostic Radiology, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Imad
authors.initials: I
authors.lastname: Zak
authors.affiliation: Teva Pharmaceutical Industries, Netanya, Israel.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ashtamker
authors.affiliation: Multiple Sclerosis Center, Wayne State University School of Medicine, Detroit, MI.|Teva Pharmaceutical Industries, Cleveland, OH.
authors.forename: Scott
authors.initials: S
authors.lastname: Kolodny
authors.affiliation: University of New Mexico School of Medicine, Albuquerque, NM.
authors.forename: Corey
authors.initials: C
authors.lastname: Ford
authors.affiliation: Teva Pharmaceutical Industries, Netanya, Israel.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Sidi
mesh_terms: D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D000068717:Glatiramer Acetate / Q000008:administration & dosage; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018696:Neuroprotective Agents / Q000008:administration & dosage
chemical_list: D018696:Neuroprotective Agents; D000068717:Glatiramer Acetate
keywords: MRI; Multiple sclerosis; disability correlates; extension study; glatiramer acetate