Axonal Damage But No Increased Glial Cell Activity in the Normal-Appearing White Matter of Patients with Clinically Isolated Syndromes Suggestive of Multiple Sclerosis Using High-Field Magnetic Resonance Spectroscopy

Wattjes, Mike P.; Harzheim, Michael; Lutterbey, G.; Klotz, Luisa; Schild, Hans H.; Träber, Frank

doi:10.3174/ajnr.a0594

Cited by 105 publications

(51 citation statements)

References 39 publications

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“…4,6 The entire brain parenchyma seems not affected (continuously) in patients with NMO. 1,26 In contrast to NMO in classic RRMS, even in very early disease stages, axonal metabolic changes and damage might be found in a subgroup of patients with RRMS, 27 whereas in other patients with RRMS, NAA levels are normal and remain stable for years (F.A.-.E., unpublished data; 2007-2009; manuscript in preparation). 28 Our MR spectroscopy data confirm the previous observation of Bichuetti et al, 26 who studied 16 patients with NMO and 16 controls, and the clinical observations found by others and ourselves.…”

Section: Discussionmentioning

confidence: 99%

Diffuse White Matter Damage Is Absent in Neuromyelitis Optica

Aboul‐Enein¹,

Krššák²,

Höftberger³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Neuromyelitis optica (NMO) is an idiopathic mostly relapsing inflammatory disease with attacks on the optic nerves and spinal cord. Whether NMO is a separate disease or a subtype of classic multiple sclerosis (MS) is unclear. Clinically, CSF and MR imaging parameters and histopathologic data suggest that the normal-appearing white matter (NAWM) may be affected in MS but not in patients with NMO. Therefore, we hypothesized that the NAWM in NMO is normal.

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Section: Discussionmentioning

confidence: 99%

Diffuse White Matter Damage Is Absent in Neuromyelitis Optica

Aboul‐Enein¹,

Krššák²,

Höftberger³

et al. 2009

AJNR Am J Neuroradiol

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“…Given the fact that axonal damage is constantly detected in patients with definite MS, first evidence for axonal damage already occurring during the first demyelinating episode has been reported in NAWM of CIS patient group with a longer median disease duration and by a whole brain MR spectroscopy analysis incorporating lesions as well as normal appearing brain tissue [32,38]. In addition to this, the significantly decreased tNAA concentrations in our study are highly indicative for a substantial axonal damage even in the NAWM of CIS patients with disease duration of approximately one month.…”

Section: Discussionmentioning

confidence: 99%

“…The concentration values and ratios in our healthy control group have been described in detail elsewhere [32]. Typical spectra from a patient presenting with CIS and from a healthy control are illustrated in Fig.…”

Section: ■ 1 H-mrsmentioning

confidence: 99%

High field MR imaging and 1H-MR spectroscopy in clinically isolated syndromes suggestive of multiple sclerosis

et al. 2007

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“…Recently published single voxel 1 H-MRS studies in CIS patients including an optimized acquisition protocol for tNAA and mIns (short and long echo time acquisition) demonstrated that axonal damage is already present in CIS patients not fulfilling the criteria for definite MS [74]. A significant increase of mIns could be observed in patients with an early disease course of relapsing-remitting MS but not in patients presenting with a CIS.…”

Section: Quantitative Mri Methodsmentioning

confidence: 99%

High field MRI in the diagnosis of multiple sclerosis: high field–high yield?

Wattjes

Barkhof

2009

Neuroradiology

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Following the approval of the U.S. Food and Drug Administration (FDA), high field magnetic resonance imaging (MRI) has been increasingly incorporated into the clinical setting. Especially in the field of neuroimaging, the number of high field MRI applications has been increased dramatically. Taking advantage on increased signal-to-noise ratio (SNR) and chemical shift, higher magnetic field strengths offer new perspectives particularly in brain imaging and also challenges in terms of several technical and physical consequences. Over the past few years, many applications of high field MRI in patients with suspected and definite multiple sclerosis (MS) have been reported including conventional and quantitative MRI methods. Conventional pulse sequences at 3 T offers higher lesion detection rates when compared to 1.5 T, particularly in anatomic regions which are important for the diagnosis of patients with MS. MR spectroscopy at 3 T is characterized by an improved spectral resolution due to increased chemical shift allowing a better quantification of metabolites. It detects significant axonal damage already in patients presenting with clinically isolated syndromes and can quantify metabolites of special interest such as glutamate which is technically difficult to quantify at lower field strengths. Furthermore, the higher susceptibility and SNR offer advantages in the field of functional MRI and diffusion tensor imaging. The recently introduced new generation of ultra-high field systems beyond 3 T allows scanning in submillimeter resolution and gives new insights into in vivo MS pathology on MRI. The objectives of this article are to review the current knowledge and level of evidence concerning the application of high field MRI in MS and to give some ideas of research perspectives in the future.

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Axonal Damage But No Increased Glial Cell Activity in the Normal-Appearing White Matter of Patients with Clinically Isolated Syndromes Suggestive of Multiple Sclerosis Using High-Field Magnetic Resonance Spectroscopy

Cited by 105 publications

References 39 publications

Diffuse White Matter Damage Is Absent in Neuromyelitis Optica

Diffuse White Matter Damage Is Absent in Neuromyelitis Optica

High field MR imaging and 1H-MR spectroscopy in clinically isolated syndromes suggestive of multiple sclerosis

High field MRI in the diagnosis of multiple sclerosis: high field–high yield?

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