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Altered hypothalamic metabolism in early multiple sclerosis - MR spectroscopy study.

Petra Hnilicová¹, Ema Kantorová², Hubert Poláček³

¹Biomedical Center Martin - Division of Neurosciences, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.

Journal of the Neurological Sciences

|October 18, 2019

Summary

Early multiple sclerosis (MS) shows hypothalamic metabolic changes, including reduced neuro-axonal markers and increased glutamate, linked to disability. These findings suggest glutamate excitotoxicity plays a key role in early MS pathogenesis.

Keywords:

(1)H MRS Glutamate excitotoxicity Hypothalamus Multiple sclerosis

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Published on: February 28, 2021

Area of Science:

Neuroscience
Metabolic Research
Clinical Neurology

Background:

Multiple sclerosis (MS) involves neuroinflammation and neuro-axonal degeneration.
Hypothalamo-pituitary axis disturbances in MS are thought to influence neuroinflammation.
Hypothalamic metabolic alterations in early MS remain poorly understood.

Purpose of the Study:

To investigate hypothalamic metabolism in early MS patients using proton magnetic resonance spectroscopy (¹H MRS).
To compare metabolite ratios in the hypothalamus of early MS patients and healthy controls.
To correlate metabolite ratios with clinical disability (Expanded Disability Status Scale - EDSS).

Main Methods:

¹H MRS was performed on the hypothalamus of 31 pre-treatment early MS patients and 31 healthy controls using a 1.5 T MR scanner.
Key metabolite ratios analyzed included tNAA/tCr, Glx/tCr, Glx/tNAA, mIns/tNAA, and tCho/tNAA.
Correlations between metabolite ratios and EDSS scores were assessed.

Main Results:

Early MS patients exhibited decreased tNAA/tCr and increased tCho/tNAA, mIns/tNAA, Glx/tCr, and Glx/tNAA compared to controls.
tCho/tNAA, Glx/tNAA, and mIns/tNAA positively correlated with EDSS.
tNAA/tCr negatively correlated with EDSS.

Conclusions:

Reduced tNAA ratios indicate neuro-axonal dysfunction in the hypothalamus of early MS patients.
Elevated glutamate (Glx) ratios suggest glutamate excitotoxicity may contribute to neuro-axonal damage.
Increased mIns and tCho ratios, alongside neuro-axonal decline, point to microglial activation and myelin degradation, highlighting glutamate excitotoxicity's role in early MS.