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F. Pietrolucci, P. Menduno, F. Riccitelli, G. Laudato, B. Iaccheri, F. Florio, M. Ricci, T. Fiore, C. Cagini; Brain Metabolite Changes in Cortical Grey and Normal-Appearing White Matter in Clinically Isolated Syndromes Suggestive of Multiple Sclerosis Presenting As Optic Neuritis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):613. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
In 85% of young adults with multiple sclerosis (MS), onset is a subacute clinically isolated syndrome (CIS) of the optic nerves, brainstem, or spinal cord. The aim of this study was to determine the prognostic value of metabolic alterations in the normal-appearing white matter (NAWM) of patients presenting with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) with special regard to the prediction of conversion to definite MS.
Using a 3T whole-body MR system, a multisequence conventional MRI protocol and single-voxel proton MR spectroscopy ( repetition time 3000 ms, echo times 14/84 ms ) of the parietal NAWM were performed in 30 patients presenting with CIS as optic neuritis at baseline and in 20 controls. NAWM and CGM metabolite concentrations of N-acetyl-aspartate (tNAA), myo-inositol (Ins), choline (Cho) and creatine (tCr) were determined at baseline and 6, 12,18 and 24 months after the initial event. Follow-up including neurological assessment and conventional MRI was performed at baseline and 6, 12,18 and 24 months after the initial event.
11 patients converted to definite MS during the follow-up period. Compared to no converters, those patients who converted to MS showed significantly lower tNAA concentrations ( P < 0.01) and higher Ins concentrations ( P < 0.01) in the NAWM and CGM. No significant differences were observed for tCr and Cho between converters and non converters. Finally, no significant differences were observed for tNAA, Ins, Cho and tCr concentrations between non converters group and control group.
tNAA and Ins brain concentrations might be a sufficient prognostic marker for patients with CIS of Optic Neuritis for a higher risk of conversion to early definite MS.
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