Global N-acetylaspartate declines even in benign multiple sclerosis.

Area of Science:

• Neurology
• Neuroimaging

Background:

• Multiple Sclerosis (MS) is characterized by neuro-axonal damage.
• A subset of MS patients exhibits a clinically benign disease course.

Purpose of the Study:

• To investigate neuro-axonal dysfunction in patients with benign MS.
• To determine if low N-acetylaspartate (NAA) levels correlate with a benign MS course.

Main Methods:

• Whole-head (1)H-MR spectroscopy was used to measure NAA.
• 43 patients with benign Relapsing-Remitting MS (RRMS) were analyzed.
• NAA concentration was normalized to brain volume (WBNAA).

Main Results:

• Patients with benign MS had significantly lower WBNAA (35% lower than controls, P < .001).
• The average rate of NAA loss was approximately 1.7% per year.
• WBNAA did not correlate with lesion load or Expanded Disability Status Scale (EDSS) scores.

Conclusions:

• Normal WBNAA is not characteristic of benign MS.
• Benign MS patients may have compensatory mechanisms but are at risk for future decline.
• Early detection of neuro-axonal damage is vital for managing MS patients.