Quantitative cervical spinal cord 3T proton MR spectroscopy in multiple sclerosis

Area of Science:

• Neuroimaging
• Biochemistry
• Neurology

Background:

• Proton MR spectroscopy ((1)H-MR spectroscopy) is valuable for assessing neuronal damage and demyelination in multiple sclerosis (MS).
• Spinal cord lesions are significant contributors to MS-related disability.
• Investigating cervical spinal cord disease using spectroscopy is challenging but crucial for MS staging and severity assessment.

Purpose of the Study:

• To measure main metabolites in cervical spinal cord plaques of relapsing-remitting MS (RRMS) patients using 3T (1)H-MR spectroscopy.
• To compare these metabolite measurements with those of healthy volunteers.
• To explore the potential of in vivo (1)H-MR spectroscopy for evaluating spinal cord integrity in MS.

Main Methods:

• Utilized a (1)H-MR point-resolved spectroscopy sequence with a volume of interest placed between C2 and C3 levels in 15 RRMS patients.
• Acquisition time was approximately 14 minutes per patient.
• Analyzed data using the LCModel fitting routine, expressing relative metabolite concentrations as absolute concentration ratios and compared with published healthy controls using a Student t test.

Main Results:

• Observed a significant decrease in total N-acetylaspartate/choline ratio in MS plaques compared to healthy tissue.
• Detected a significant increase in choline/creatine and myo-inositol/creatine ratios in MS plaques.
• These findings indicate specific biochemical alterations in the cervical spinal cord in RRMS.

Conclusions:

• In vivo (1)H-MR spectroscopy shows promise as a reliable tool for clinical studies in MS, comparable to its use in brain imaging.
• This technique enables biochemical examination of spinal cord integrity.
• It may be sensitive to subtle, progressive changes in the course of MS disease.