Human brain proton localized NMR spectroscopy in multiple sclerosis.

Area of Science:

• Neuroimaging
• Biochemistry
• Medical Physics

Background:

• Multiple Sclerosis (MS) is a chronic neurological disease.
• Brain metabolite alterations are implicated in MS pathogenesis.
• Proton spectroscopy offers a non-invasive method to assess brain biochemistry.

Purpose of the Study:

• To investigate brain metabolite changes in MS patients using localized proton spectroscopy.
• To compare spectroscopic findings between MS patients and healthy controls.
• To explore the relationship between metabolite ratios and MS plaque burden.

Main Methods:

• Localized proton spectroscopy performed on 18 MS patients and 17 controls using a 1.5-T MRI scanner.
• Stimulated echo method with selective water suppression was employed.
• Regions of Interest (VOIs) were selected in the white matter, prioritizing plaque areas in MS patients.

Main Results:

• Key metabolites detected: Choline (Cho), Phosphocreatine + Creatine (PCr + Cr), and N-acetylaspartate (NAA).
• MS patients with plaques showed significantly lower NAA/Cho (1.98 ± 0.33) and NAA/(PCr + Cr) (2.16 ± 0.14) ratios compared to controls (2.54 ± 0.39 and 2.76 ± 0.25, respectively).
• MS patients without detectable plaques exhibited metabolite ratios similar to controls, though this subgroup was too small for definitive conclusions.

Conclusions:

• Localized proton spectroscopy can detect biochemical alterations in the MS brain.
• Reduced NAA levels, indicated by lower NAA/Cho and NAA/(PCr + Cr) ratios, are associated with MS plaques.
• These findings suggest potential for proton spectroscopy as a biomarker in MS research and clinical assessment.