Contributions
Abstract: P505
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Objective: Advanced MR technologies, such as 1D magnetic resonance spectroscopy (MRS) have been applied to multiple sclerosis previously to investigate metabolic changes in the brain of multiple sclerosis (MS) patients and to offer potential biomarkers for disease monitoring. For the first time, we have applied in-vivo two-dimensional (2D) Localized COrrelation SpectroscopY (2D L-COSY), an innovative MRS technique in relapsing and remitting multiple sclerosis (RRMS) in order to identify the optimal MR biomarker to monitor disease activity.
Methods: 2D L-COSY MRS spectra was prospectively acquired from a 3x3x3cm3 voxel located in the posterior cingulate gyrus (PCG) from 45 stable RRMS patients undergoing treatment with Fingolimod and 40 age and gender-matched healthy control participants (HC). Mean metabolites and clinical correlates including cognitive, fatigue and mental health parameters were calculated and compared using parametric and non-parametric tests. Whole brain volume and voxel morphology were evaluated using SIENAX and SPM LST toolbox.
Results: Mean lesion volume was 6.8mls. Out of all metabolites measured, the NAA metabolic fingerprints most accurately distinguish MS from healthy controls using the Wald test for logistic regression (12.9; p < 0.001 after adjusting for age and sex). NAA peaks are closely correlated with most atrophy measures (r=0.487; p< 0.01). In a cohort with only minimal cognitive impairment, only visuospatial function and attention were correlated with metabolites in the brain (NAA_1 Pearson's correlation -0.42; p< 0.01; GABA and NAA_3 -0.36; p< 0.05; Glx -0.37 p< 0.01). Out of all brain volume measurements grey matter volume (GMV) and total lesion volume (TLV) are most closely associated with cognitive function (GMV: 0.39; TLV: -0.401; p< 0.01) and disease severity (GMV: -0.495; TLV 0.463; p< 0.01). None of the parameters tested predicted fatigue, depression, anxiety or stress.
Conclusions: 2D L-COSY has the potential to detect metabolites that distinguish healthy from MS brain even if the lesion load is minimal. Despite only examining a localized region, we could detect metabolic variability associated with symptoms. In future, whole brain MRS might offer additional essential information to monitor MS.
Disclosure: Scott Quadrelli: nothing to disclose
Karen Ribbons: nothing to disclose
Rodney Lea: nothing to disclose
Jameen Arm: nothing to disclose
Oun Al-Iedani: nothing to disclose
Saadallah Ramadan: nothing to disclose
Jeannette Lechner-Scott: has accepted travel compensation from Novartis, Biogen and Merck Serono. Her institution receives the honoraria for talks and advisory board commitment and also clinic support from Bayer Health Care, Biogen Idec, CSL, Genzyme Sanofi, Merck Serono, Novartis and Teva.
Abstract: P505
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Objective: Advanced MR technologies, such as 1D magnetic resonance spectroscopy (MRS) have been applied to multiple sclerosis previously to investigate metabolic changes in the brain of multiple sclerosis (MS) patients and to offer potential biomarkers for disease monitoring. For the first time, we have applied in-vivo two-dimensional (2D) Localized COrrelation SpectroscopY (2D L-COSY), an innovative MRS technique in relapsing and remitting multiple sclerosis (RRMS) in order to identify the optimal MR biomarker to monitor disease activity.
Methods: 2D L-COSY MRS spectra was prospectively acquired from a 3x3x3cm3 voxel located in the posterior cingulate gyrus (PCG) from 45 stable RRMS patients undergoing treatment with Fingolimod and 40 age and gender-matched healthy control participants (HC). Mean metabolites and clinical correlates including cognitive, fatigue and mental health parameters were calculated and compared using parametric and non-parametric tests. Whole brain volume and voxel morphology were evaluated using SIENAX and SPM LST toolbox.
Results: Mean lesion volume was 6.8mls. Out of all metabolites measured, the NAA metabolic fingerprints most accurately distinguish MS from healthy controls using the Wald test for logistic regression (12.9; p < 0.001 after adjusting for age and sex). NAA peaks are closely correlated with most atrophy measures (r=0.487; p< 0.01). In a cohort with only minimal cognitive impairment, only visuospatial function and attention were correlated with metabolites in the brain (NAA_1 Pearson's correlation -0.42; p< 0.01; GABA and NAA_3 -0.36; p< 0.05; Glx -0.37 p< 0.01). Out of all brain volume measurements grey matter volume (GMV) and total lesion volume (TLV) are most closely associated with cognitive function (GMV: 0.39; TLV: -0.401; p< 0.01) and disease severity (GMV: -0.495; TLV 0.463; p< 0.01). None of the parameters tested predicted fatigue, depression, anxiety or stress.
Conclusions: 2D L-COSY has the potential to detect metabolites that distinguish healthy from MS brain even if the lesion load is minimal. Despite only examining a localized region, we could detect metabolic variability associated with symptoms. In future, whole brain MRS might offer additional essential information to monitor MS.
Disclosure: Scott Quadrelli: nothing to disclose
Karen Ribbons: nothing to disclose
Rodney Lea: nothing to disclose
Jameen Arm: nothing to disclose
Oun Al-Iedani: nothing to disclose
Saadallah Ramadan: nothing to disclose
Jeannette Lechner-Scott: has accepted travel compensation from Novartis, Biogen and Merck Serono. Her institution receives the honoraria for talks and advisory board commitment and also clinic support from Bayer Health Care, Biogen Idec, CSL, Genzyme Sanofi, Merck Serono, Novartis and Teva.