Abstract
BackgroundThe latest diagnostic criteria for multiple sclerosis (MS) have revitalized the role of oligoclonal bands synthesis in the cerebrospinal fluid (CSF-OCB). This study identifies predictors of CSF-OCB-positivity among in vivo metabolic markers in the subcortical gray/white matter in MS patients after their first episode (CIS) and in patients with relapsing-remitting course (RRMS). MethodsThe study enrolled 13 CIS and 23 RRMS patients. Metabolism was evaluated using Mescher-Garwood-edited proton-magnetic resonance spectroscopy on a 3T MR scanner. In addition to N-acetyl-aspartate (tNAA), myoinositol (mIns), and choline- and creatine compounds (tCho, tCr) were also evaluated γ-aminobutyric acid (GABA) and glutamate-glutamine (Glx) ratios. ResultsCSF-OCB-positivity was found in 76.9% of CIS and 78.2% of RRMS patients. GABA and Glx ratios in putamen and corpus callosum strongly determined CSF-OCB-positive CIS patients. Other essential predictors of CSF-OCB-positive CIS were mIns and Glx ratios in the putamen, and tCho/tNAA in the corpus callosum. In RRMS, GABA ratios in the right thalamus and Glx ratios in the left hippocampus strongly predicted CSF-OCB-positive patients. tCho/tNAA and tNAA/tCr in the left hippocampus were also identified as essential predictors of CSF-OCB-positive RRMS patients. ConclusionThis is the first in vivo evidence of GABA-Glx rearrangement in CSF-OCB-positive patients since its early stages of MS.
Highlights
Multiple sclerosis (MS) is the most typical demyelinating disease affecting the central nervous system (CNS), characterized as an in flammatory disease involving myelin loss and neuro-axonal damage, which leads to progressive neurological dysfunction (Dutta et al, 2006; Messina & Patti, 2014)
Our study evaluates the relationship between metabolism in subcortical gray/white matter (SGWM) measured by advanced GABA-edited 1H MRS and CSF-OCB synthesis in multiple sclerosis (MS) regarding the dis ease course
All clinical episode of MS (CIS) and relapsing-remitting course (RRMS) patients were evaluated separately due to different clinical characteristics, their CSF-OCB-positive and CSFOCB-negative subgroups
Summary
Multiple sclerosis (MS) is the most typical demyelinating disease affecting the central nervous system (CNS), characterized as an in flammatory disease involving myelin loss and neuro-axonal damage, which leads to progressive neurological dysfunction (Dutta et al, 2006; Messina & Patti, 2014). This study identifies predictors of CSF-OCB-positivity among in vivo metabolic markers in the subcortical gray/white matter in MS patients after their first episode (CIS) and in patients with relapsing-remitting course (RRMS). Results: CSF-OCB-positivity was found in 76.9% of CIS and 78.2% of RRMS patients. GABA and Glx ratios in putamen and corpus callosum strongly determined CSF-OCB-positive CIS patients. Other essential predictors of CSF-OCB-positive CIS were mIns and Glx ratios in the putamen, and tCho/tNAA in the corpus callosum. In RRMS, GABA ratios in the right thalamus and Glx ratios in the left hippocampus strongly predicted CSF-OCB-positive patients. TCho/tNAA and tNAA/tCr in the left hippocampus were identified as essential predictors of CSFOCB-positive RRMS patients.
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