Axonal injury in early multiple sclerosis is irreversible and independent of the short-term disease evolution

M. Rovaris, A. Gambini, A. Gallo, A. Falini, A. Ghezzi, B. Benedetti, M. P. Sormani, V. Martinelli, G. Comi, M. Filippi

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Abstract

Objective: To define the nature and the temporal evolution of neuronal/axonal injury in patients at the earliest clinical stage of multiple sclerosis (MS), using whole brain N-acetylaspartate (WBNAA) proton MR spectroscopy ( 1H-MRS). Methods: Thirty-five patients at presentation with clinically isolated syndromes (CIS) and MRI evidence of disease dissemination in space were studied. The following scans of the brain were acquired within 3 months from the onset of the disease and after 12 months: 1) dual-echo; 2) WBNAA 1H-MRS; 3) pre- and postcontrast T1-weighted. The same scans were obtained in 12 age-matched healthy subjects, without contrast administration. In patients, conventional MRI scans were also repeated 3 months after the first scanning session, to assess the presence of early disease dissemination in time (DIT). Results: Over the study period, 24 patients showed MRI evidence of disease DIT, thus fulfilling the criteria for a diagnosis of MS. The average WBNAA amount was lower in CIS patients than in controls both at baseline (13.7 vs 16.9 mM, p <0.001) and at 1-year follow-up (12.6 vs 16.2 mM, p <0.001), but the average yearly percentage change of WBNAA did not differ between the two groups. No MRI or 1H-MRS quantities were significantly associated with the disease DIT over the study period. Conclusion: Irreversible brain damage associated with axonal dysfunction occurs at a very early stage in patients with clinically isolated syndromes, but it does not seem to be related with the disease evolution in the subsequent short-term period.

Original languageEnglish
Pages (from-to)1626-1630
Number of pages5
JournalNeurology
Volume65
Issue number10
DOIs
Publication statusPublished - Nov 2005

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Multiple Sclerosis
Wounds and Injuries
Brain
Protons
Healthy Volunteers
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
N-acetylaspartate
Proton Magnetic Resonance Spectroscopy

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Axonal injury in early multiple sclerosis is irreversible and independent of the short-term disease evolution. / Rovaris, M.; Gambini, A.; Gallo, A.; Falini, A.; Ghezzi, A.; Benedetti, B.; Sormani, M. P.; Martinelli, V.; Comi, G.; Filippi, M.

In: Neurology, Vol. 65, No. 10, 11.2005, p. 1626-1630.

Research output: Contribution to journalArticle

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abstract = "Objective: To define the nature and the temporal evolution of neuronal/axonal injury in patients at the earliest clinical stage of multiple sclerosis (MS), using whole brain N-acetylaspartate (WBNAA) proton MR spectroscopy ( 1H-MRS). Methods: Thirty-five patients at presentation with clinically isolated syndromes (CIS) and MRI evidence of disease dissemination in space were studied. The following scans of the brain were acquired within 3 months from the onset of the disease and after 12 months: 1) dual-echo; 2) WBNAA 1H-MRS; 3) pre- and postcontrast T1-weighted. The same scans were obtained in 12 age-matched healthy subjects, without contrast administration. In patients, conventional MRI scans were also repeated 3 months after the first scanning session, to assess the presence of early disease dissemination in time (DIT). Results: Over the study period, 24 patients showed MRI evidence of disease DIT, thus fulfilling the criteria for a diagnosis of MS. The average WBNAA amount was lower in CIS patients than in controls both at baseline (13.7 vs 16.9 mM, p <0.001) and at 1-year follow-up (12.6 vs 16.2 mM, p <0.001), but the average yearly percentage change of WBNAA did not differ between the two groups. No MRI or 1H-MRS quantities were significantly associated with the disease DIT over the study period. Conclusion: Irreversible brain damage associated with axonal dysfunction occurs at a very early stage in patients with clinically isolated syndromes, but it does not seem to be related with the disease evolution in the subsequent short-term period.",
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AU - Gallo, A.

AU - Falini, A.

AU - Ghezzi, A.

AU - Benedetti, B.

AU - Sormani, M. P.

AU - Martinelli, V.

AU - Comi, G.

AU - Filippi, M.

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