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1. Serum and CSF N-acetyl aspartate Levels differ in multiple sclerosis and neuromyelitis optica

Author

Edmondo Ceci, Mariangela Mastrapasqua, Anna Maria Simone, Francesco Patti, Emanuele D'Amico, Pietro Iaffaldano, Maria Trojano, Maria Pia Amato, Patrizia Sola, Alessandra Lugaresi, Direnzo, Paolo Livrea, Antonio Frigeri, A. Ghezzi, De Luca G, Maddalena Ruggieri, Bahia Hakiki, Maria Svelto, Di Monte E, Carla Tortorella, Tortorella C, Ruggieri M, Di Monte E, Ceci E, Iaffaldano P, Direnzo V, Mastrapasqua M, Frigeri A, Amato MP, Hakiki B, Ghezzi A, Lugaresi A, De Luca G, Patti F, D'amico E, Sola P, Simone AM, Svelto M, Livrea P, and Trojano M.

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Adolescent, Axonal pathology, Diagnosis, Differential, Multiple Sclerosis, Relapsing-Remitting, immune system diseases, Neuronal damage, mental disorders, medicine, Humans, Aged, Aspartic Acid, Neuromyelitis optica, business.industry, Multiple sclerosis, Neuromyelitis Optica, Middle Aged, Serum samples, N acetyl aspartate, medicine.disease, Response to treatment, nervous system diseases, Psychiatry and Mental health, nervous system, Case-Control Studies, Surgery, Female, multiple sclerosis,neuromyelitis optica, N-acetyl aspartate, CSF, Neurology (clinical), Differential diagnosis, business, Biomarkers
Abstract

Background The identification of biomarkers able to improve the differential diagnosis between multiple sclerosis (MS) and neuromyelitis optica (NMO) is challenging because of a different prognosis and response to treatment. Growing evidence indicates that brain and CSF N-acetyl aspartate (NAA) concentration is a useful marker for characterising different phases of axonal pathology in demyelinating diseases, and preliminary studies suggest that increased serum NAA levels may be a telltale sign of acute neuronal damage or defective NAA metabolism in oligodendrocytes. Objective To evaluate whether serum and CSF NAA concentration differs in patients with MS and NMO. Design Observational, multicentre, prospective, cross sectional study. Methods Serum samples were collected from 48 relapsingeremitting MS, 32 NMO and 76 age matched healthy controls. Coeval CSF samples were available for all MS and for 8/32 NMO patients. NAA was measured in serum and CSF by liquid chromatography-mass spectrometry. Results MS patients showed higher serum and CSF NAA levels than NMO patients, and higher serum NAA levels than healthy controls (p

Published
2011

2. Serum and CSF N-acetyl aspartate levels differ in multiple sclerosis and neuromyelitis optica.

Author

Tortorella, C., Ruggieri, M., Di Monte, E., Ceci, E., Iaffaldano, P., Direnzo, V., Mastrapasqua, M., Frigeri, A., Amato, M. P., Hakiki, B., Ghezzi, A., Lugaresi, A., De Luca, G., Patti, F., D'amico, E., Sola, P., Simone, A. M., Svelto, M., Livrea, P., and Trojano, M.

Subjects
MULTIPLE sclerosis, AUTOIMMUNE diseases, BIOMARKERS, SERUM, ASPARTATES, CEREBROSPINAL fluid, DIFFERENTIAL diagnosis, PROGNOSIS
Abstract

Background The identification of biomarkers able to improve the differential diagnosis between multiple sclerosis (MS) and neuromyelitis optica (NMO) is challenging because of a different prognosis and response to treatment. Growing evidence indicates that brain and CSF N-acetyl aspartate (NAA) concentration is a useful marker for characterising different phases of axonal pathology in demyelinating diseases, and preliminary studies suggest that increased serum NAA levels may be a telltale sign of acute neuronal damage or defective NAA metabolism in oligodendrocytes. Objective To evaluate whether serum and CSF NAA concentration differs in patients with MS and NMO. Design Observational, multicentre, prospective, cross sectional study. Methods Serum samples were collected from 48 relapsingeremitting MS, 32 NMO and 76 age matched healthy controls. Coeval CSF samples were available for all MS and for 8/32 NMO patients. NAA was measured in serum and CSF by liquid chromatographyemass spectrometry. Results MS patients showed higher serum and CSF NAA levels than NMO patients, and higher serum NAA levels than healthy controls (p<0.001). High serum NAA values, exceeding the 95th percentile of serum NAA values in healthy controls, were found in 100% of patients with MS and in no patient with NMO. No differences in serum NAA levels were found between NMO and healthy controls. In MS, serum and CSF NAA levels correlated with disability score. Conclusions Determination of serum and CSF NAA levels may represent a suitable tool in the diagnostic laboratory workup to differentiate MS and NMO. [ABSTRACT FROM AUTHOR]

Published
2011
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