Contributions
Abstract: P488
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Magnetic resonance spectroscopy (MRS) is a non-invasive imaging technique used to measure changes in the concentration of metabolites in a specific, predefined area of the brain that might appear otherwise normal using conventional MRI. The thalamus is a deep grey matter structure in the brain, and is highly connected with both white matter tracts and cortical grey matter. We postulate that thalamic MRS may be a biomarker of global pathology in the MS central nervous system, and may be responsive to changes in metabolite levels after treatment with disease modifying therapy.
Objective: To compare the concentration of metabolites in the thalamus of patients with highly active MS and healthy controls using MRS and to quantify the changes in metabolite concentration after natalizumab treatment.
Methods: Thalamic MRS was performed on 17 patients with highly active MS, all of whom were scheduled to initiate natalizumab treatment, and 12 age-matched healthy controls. Thalamic MRS was repeated after 3 months and 13 months of natalizumab treatment, and clinical data collected.
Results: Concentration of glutamate (Glu), a marker of glutamatergic neurotransmission and glutamatergic metabolic functions, was lower in the thalami of MS patients compared to healthy controls (p< 0.05), and was strongly negatively correlated with total lesion volume (r=-0.80, p< 0.01). After 3 months and 13 months of natalizumab treatment concentration of glutamate did not change, but concentration of creatine-phosphocreatine (Cr-PCr), a marker of metabolic activity, decreased significantly (p< 0.05). Correlations between changes in metabolites and clinical response to treatment will be reported.
Conclusions: MRS of thalamic glutamate may be a good surrogate for global MS pathology which is not influenced by current disease modifying therapy. Thalamic creatine-phosphocreatine may respond to metabolic changes caused by treatment effects. Further research is warranted to investigate whether thalamic MRS can predict long-term prognosis, and long-term response to disease modifying treatment in MS.
Disclosure: Luisa Peress: nothing to disclose.
Ines Ribeiro Violante: nothing to disclose.
Gregory Scott: nothing to disclose.
Karl Zimmerman: nothing to disclose.
David Sharp: nothing to disclose.
Richard Nicholas: Bayer, Biogen, Genzyme, Merck Serono, Roche - honorarium for speaking, advisory boards. Biogen, Genzyme, Novartis - funds for organising education, staff. Biogen, Novartis - Principal investigator.
Joel Raffel: nothing to disclose.
Abstract: P488
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Magnetic resonance spectroscopy (MRS) is a non-invasive imaging technique used to measure changes in the concentration of metabolites in a specific, predefined area of the brain that might appear otherwise normal using conventional MRI. The thalamus is a deep grey matter structure in the brain, and is highly connected with both white matter tracts and cortical grey matter. We postulate that thalamic MRS may be a biomarker of global pathology in the MS central nervous system, and may be responsive to changes in metabolite levels after treatment with disease modifying therapy.
Objective: To compare the concentration of metabolites in the thalamus of patients with highly active MS and healthy controls using MRS and to quantify the changes in metabolite concentration after natalizumab treatment.
Methods: Thalamic MRS was performed on 17 patients with highly active MS, all of whom were scheduled to initiate natalizumab treatment, and 12 age-matched healthy controls. Thalamic MRS was repeated after 3 months and 13 months of natalizumab treatment, and clinical data collected.
Results: Concentration of glutamate (Glu), a marker of glutamatergic neurotransmission and glutamatergic metabolic functions, was lower in the thalami of MS patients compared to healthy controls (p< 0.05), and was strongly negatively correlated with total lesion volume (r=-0.80, p< 0.01). After 3 months and 13 months of natalizumab treatment concentration of glutamate did not change, but concentration of creatine-phosphocreatine (Cr-PCr), a marker of metabolic activity, decreased significantly (p< 0.05). Correlations between changes in metabolites and clinical response to treatment will be reported.
Conclusions: MRS of thalamic glutamate may be a good surrogate for global MS pathology which is not influenced by current disease modifying therapy. Thalamic creatine-phosphocreatine may respond to metabolic changes caused by treatment effects. Further research is warranted to investigate whether thalamic MRS can predict long-term prognosis, and long-term response to disease modifying treatment in MS.
Disclosure: Luisa Peress: nothing to disclose.
Ines Ribeiro Violante: nothing to disclose.
Gregory Scott: nothing to disclose.
Karl Zimmerman: nothing to disclose.
David Sharp: nothing to disclose.
Richard Nicholas: Bayer, Biogen, Genzyme, Merck Serono, Roche - honorarium for speaking, advisory boards. Biogen, Genzyme, Novartis - funds for organising education, staff. Biogen, Novartis - Principal investigator.
Joel Raffel: nothing to disclose.