1. The association between retinal nerve fibre layer thickness and N-acetyl aspartate levels in multiple sclerosis brain normal-appearing white matter: A longitudinal study using magnetic resonance spectroscopy and optical coherence tomography
- Author
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Esther Ruberte, Özgür Yaldizli, J. Würfel, Norman Putzki, Jens Kuhle, M Pardini, C. Valmaggia, D. Botzkowski, Achim Gass, Jochen Vehoff, Stefanie Müller, and Barbara Tettenborn
- Subjects
Adult ,Male ,N-acetyl aspartate ,Creatine ,Sensitivity and Specificity ,White matter ,Multiple sclerosis ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Optical coherence tomography ,Magnetic resonance spectroscopy ,Retinal nerve fibre layer thickness ,Medicine (all) ,Neurology ,Neurology (clinical) ,Medicine ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,Aspartic Acid ,Clinically isolated syndrome ,Expanded Disability Status Scale ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,Axons ,medicine.anatomical_structure ,Multiple sclerosis functional composite ,chemistry ,Disease Progression ,Female ,business ,Nuclear medicine ,030217 neurology & neurosurgery ,Tomography, Optical Coherence ,Retinal Neurons - Abstract
BACKGROUND AND PURPOSE N-acetyl aspartate (NAA) assessed using proton magnetic resonance spectroscopy (1 H MRS) has a high pathological specificity for axonal density. Retinal nerve fibre layer thickness (RNFLT) measured by using optical coherence tomography is increasingly used as a surrogate marker of neurodegeneration in multiple sclerosis (MS). Our aim was to investigate the relation between RNFLT and NAA/creatine in brain normal-appearing white matter (NAWM), their dynamics over time and the association with clinical outcome measures in relapsing MS. T2 WM lesions served as control tissue. METHODS Forty-three MS patients underwent standardized neurological examination including the Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC) score, optical coherence tomography and magnetic resonance imaging including 1 H MRS at baseline and after 1 year. RESULTS At baseline, NAA/creatine level was lower in T2 WM lesions than in NAWM (1.64 ± 0.16 vs. 1.88 ± 0.24, P < 0.001). Lowest levels were found in secondary progressive MS (SPMS). Mean RNFLT was higher in clinically isolated syndrome than in the combined group of relapsing-remitting MS and SPMS (99.8 ± 12.3 μm vs. 92.4 ± 12.8 μm, P = 0.038). In all patients, mean RNFLT decreased by 1.4% during follow-up. At baseline, MSFC z-scores correlated with NAA/creatine levels both in NAWM (r = 0.42; P = 0.008) and T2 WM lesions (r = 0.52, P = 0.004). NAWM NAA/creatine variation correlated with the RNFLT change over 1 year (ρ = 0.43, P = 0.046). CONCLUSIONS N-acetyl aspartate/creatine level reduction correlated with RNFLT thinning over 1 year in an EDSS stable MS cohort suggesting that these techniques might be sensitive to detect subclinical disease progression.
- Published
- 2016