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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Axonal loss is progressive and partly dissociated from lesion load in early multiple sclerosis
A M Pascual1, M C Martínez-Bisbal, I Boscá
1Department of Neurology, Hospital Universitario La Fe, Avda. Campanar 21, at Valencia. E. 46009, Valencia, Spain. med004201@saludalia.com
Neurology
|July 4, 2007
Summary
Early relapsing-remitting multiple sclerosis shows progressive axonal damage, detectable via spectroscopy. Axonal loss and lesion volume appear dissociated in early disease stages.
Area of Science:
- Neuroscience
- Radiology
- Biochemistry
Background:
- Multiple Sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
- Relapsing-remitting MS (RRMS) is the most common form, characterized by distinct attacks and remissions.
- Early detection of axonal damage is crucial for understanding disease progression.
Purpose of the Study:
- To investigate the relationship between spectroscopically measured axonal damage in normal-appearing white matter (NAWM) of the brainstem.
- To correlate axonal damage with T2-hyperintense lesion volume (T2LV) and disability in early RRMS patients.
- To assess changes over a 2-year follow-up period.
Main Methods:
- Prospective study of 43 RRMS patients and 10 healthy controls over 2 years.
- Acquisition of T2-weighted MRI and proton MR spectroscopy at baseline and year 2.
- Analysis of N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) ratios in the brainstem to quantify axonal damage.
Main Results:
- RRMS patients showed decreased basal NAA/Cho ratios compared to controls.
- Over 2 years, RRMS patients exhibited reduced NAA/Cho and NAA/Cr ratios and increased T2LV.
- Axonal damage (NAA/Cr decrease) occurred in all RRMS patients, while T2LV increased only in those with relapses.
Conclusions:
- Early and progressive axonal damage is evident in RRMS.
- Axonal loss and T2 lesion volume appear to be partially dissociated processes in early RRMS.
- Spectroscopic assessment of brainstem NAWM can detect early axonal damage in RRMS.
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