Cortical N-acetyl aspartate is a predictor of long-term clinical disability in multiple sclerosis

TY - JOUR

T1 - Cortical N-acetyl aspartate is a predictor of long-term clinical disability in multiple sclerosis

AU - Wu, Xingchen

AU - Hanson, Lars Grüner

AU - Skimminge, Arnold

AU - Sorensen, Per Soelberg

AU - Paulson, Olaf Bjarne

AU - Mathiesen, Henrik Kahr

AU - Blinkenberg, Morten

PY - 2014/8

Y1 - 2014/8

N2 - Objective: To evaluate the prognostic value of the cortical N-acetyl aspartate to creatine ratio (NAA/Cr) in early relapsing-remitting multiple sclerosis (RRMS). Methods: Sixteen patients with newly diagnosed RRMS were studied by serial MRI and MR spectroscopic imaging (MRSI) once every 6 months for 24 months. Clinical examinations, including the expanded disability status scale (EDSS), were performed at baseline, month 24, and at year 7. Results: Baseline cortical NAA/Cr correlated inversely with EDSS at month 24 (r = -0.61, P<0.05), and patients with EDSS ≥ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P<0.05). Baseline cortical NAA/Cr also correlated inversely with EDSS at the 7-year follow-up (r = -0.56, P<0.05), and patients with EDSS ≥ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P< 0.05). Baseline brain parenchymal fraction (BPF) correlated inversely with EDSS at month 24 (r = -0.61, P<0.05), but not with EDSS at year 7. Discussion: Cortical NAA/Cr in early RRMS correlated with clinical disability after 2 and 7 years and may be used as a predictor of long-term disease outcome.

AB - Objective: To evaluate the prognostic value of the cortical N-acetyl aspartate to creatine ratio (NAA/Cr) in early relapsing-remitting multiple sclerosis (RRMS). Methods: Sixteen patients with newly diagnosed RRMS were studied by serial MRI and MR spectroscopic imaging (MRSI) once every 6 months for 24 months. Clinical examinations, including the expanded disability status scale (EDSS), were performed at baseline, month 24, and at year 7. Results: Baseline cortical NAA/Cr correlated inversely with EDSS at month 24 (r = -0.61, P<0.05), and patients with EDSS ≥ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P<0.05). Baseline cortical NAA/Cr also correlated inversely with EDSS at the 7-year follow-up (r = -0.56, P<0.05), and patients with EDSS ≥ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P< 0.05). Baseline brain parenchymal fraction (BPF) correlated inversely with EDSS at month 24 (r = -0.61, P<0.05), but not with EDSS at year 7. Discussion: Cortical NAA/Cr in early RRMS correlated with clinical disability after 2 and 7 years and may be used as a predictor of long-term disease outcome.

KW - Adult

KW - Aspartic Acid

KW - Cerebral Cortex

KW - Creatine

KW - Disability Evaluation

KW - Disease Progression

KW - Female

KW - Humans

KW - Magnetic Resonance Spectroscopy

KW - Male

KW - Middle Aged

KW - Multiple Sclerosis

KW - Prognosis

KW - Young Adult

U2 - 10.1179/1743132813y.0000000312

DO - 10.1179/1743132813y.0000000312

M3 - Journal article

C2 - 24620975

SN - 0161-6412

VL - 36

SP - 701

EP - 708

JO - Neurological Research

JF - Neurological Research

IS - 8

ER -