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Neurol Res. 2014 Aug;36(8):701-8. doi: 10.1179/1743132813Y.0000000312. Epub 2014 Jan 21.

Cortical N-acetyl aspartate is a predictor of long-term clinical disability in multiple sclerosis.

Abstract

OBJECTIVE:

To evaluate the prognostic value of the cortical N-acetyl aspartate to creatine ratio (NAA/Cr) in early relapsing-remitting multiple sclerosis (RRMS).

METHODS:

Sixteen patients with newly diagnosed RRMS were studied by serial MRI and MR spectroscopic imaging (MRSI) once every 6 months for 24 months. Clinical examinations, including the expanded disability status scale (EDSS), were performed at baseline, month 24, and at year 7.

RESULTS:

Baseline cortical NAA/Cr correlated inversely with EDSS at month 24 (r  =  -0·61, P < 0·05), and patients with EDSS ≧ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P < 0·05). Baseline cortical NAA/Cr also correlated inversely with EDSS at the 7-year follow-up (r  =  -0·56, P < 0·05), and patients with EDSS ≧ 4 had a lower baseline cortical NAA/Cr compared to those with EDSS less than 4 (P < 0·05). Baseline brain parenchymal fraction (BPF) correlated inversely with EDSS at month 24 (r  =  -0·61, P < 0·05), but not with EDSS at year 7.

DISCUSSION:

Cortical NAA/Cr in early RRMS correlated with clinical disability after 2 and 7 years and may be used as a predictor of long-term disease outcome.

KEYWORDS:

Cortical NAA,; Cortical choline,; MRI,; MRSI,; Multiple sclerosis

PMID:
24620975
DOI:
10.1179/1743132813Y.0000000312
[Indexed for MEDLINE]

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