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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:267-271, February 2007
© 2007 American Society of Neuroradiology

BRAIN

Reproducibility of Three Whole-Brain N-Acetylaspartate Decline Cohorts in Relapsing-Remitting Multiple Sclerosis

O. Gonen^a, T.A. Oberndorfer^a, M. Inglese^a, J.S. Babb^a, J. Herbert^b and R.I. Grossman^a

^a Department of Radiology, New York University School of Medicine, New York, NY
^b Department of Neurology, New York University School of Medicine, New York, NY

Address correspondence to Oded Gonen, PhD, Department of Radiology, New York University School of Medicine, 650 First Ave, New York, NY 10016; e-mail: oded.gonen{at}med.nyu.edu

BACKGROUND AND PURPOSE: The cross-sectional rate of whole-brain N-acetylaspartate (NAA, a neuronal cell marker) loss in clinically similar relapsing-remitting multiple sclerosis (RRMS) patients has recently been shown to fall into 3 distinct decline rate strata. Our goal was to test the reproducibility of this observation in a new cohort of RRMS patients.

MATERIALS AND METHODS: Sixteen serial patients (12 women, 4 men, median age 38 [27–55] years) with clinically definite RRMS for an average of 5 (0.3–18) years’ disease duration and a mean Expanded Disability Status Score of 2.0 (0–6) were studied, once each. Their whole-brain NAA (WBNAA) amounts, obtained with proton MR spectroscopy, were divided by brain volumes (segmented from MR imaging) to yield concentrations suitable for cross-sectional comparisons.

RESULTS: Three distinct strata of cross-sectional NAA decline rates were found: –0.031, –0.32, and –1.71 mmol/L/y when disease duration was estimated from confirmed diagnosis, or –0.057, –0.20, and –1.38 mmol/L/y when measured from the first clinical symptom. These rates and their corresponding fractions of the study population were indistinguishable from those reported previously in a different group of 49 clinically similar (mean Expanded Disability Status Score also 2.0) RRMS patients.

CONCLUSION: Reproducing the previous cohort’s cross-sectional WBNAA decline characteristics in this new group of clinically similar RRMS patients indicates that 3 WBNAA loss strata may be a general attribute of MS. Consequently, WBNAA could serve as a surrogate marker for the global load of neuronal and axonal dysfunction and damage in this disease.

This article has been cited by other articles:

				D.J. Rigotti, M. Inglese, and O. Gonen Whole-Brain N-Acetylaspartate as a Surrogate Marker of Neuronal Damage in Diffuse Neurologic Disorders AJNR Am. J. Neuroradiol., November 1, 2007; 28(10): 1843 - 1849. [Abstract] [Full Text] [PDF]