Valerie Lynn Jewells DO, Presenter: Nothing to Disclose

Lester Kwock PhD, Abstract Co-Author: Nothing to Disclose

Silva Markovic-Plese MD, PhD, Abstract Co-Author: Nothing to Disclose

Yueh Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Danielle Speer RN, Abstract Co-Author: Nothing to Disclose

David Feng BS, Abstract Co-Author: Nothing to Disclose

Russell M Taylor PhD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Currently, no biomarker for multiple sclerosis (MS) exhists, and a non-invasive imaging biomaker for determination of conversion from relapsing remitting (RR) MS to secondary progressive (SP) MS will influence therapeutic decisions.  Magnetic resonance spectroscopy (MRS) provides physiologic information about metabolites, and has the potential to serve this function.  This pilot feasibility study was performed to assess whole brain MRS in RR and SP MS patients using the LC model.

25 RRMS, 10 SPMS, and 5 control subjects were sequentially enrolled in this IRB approved study via written informed consent.  3T MRS multi-volume spectroscopic 3-D point resolved imaging (3D SI PRESS) was performed superior to inferior from the centrum semi-ovale to the hypothalamus. Linear combination model spectra (LC model;version 6.01,S. Provencher, Canada) 1 cc MR spectral volumes of patients were compared to a normalized brain basis set for metabolite quantification.  Statistical anlaysis was performed using an F-test  (0.05 significance level) for the following metabolites; Creatine (Cr), Lipids (L), Myoinositol (MI), N-acetylaspartate (NAA), Phophocholine/Glycerol phosphatidylcholine (PCCGPC), Glutamate/Glutamine (G), and proteins MM14, MM9, and MM20.

The RRMS patients revealed depressed (NAA) levels as reported by previous authors both in lesions and in the normal appearing white matter with a periventricular predisposition. Also identified were elvated L and G levels. Comparison of the RRMS and SPMS groups identified statisticaly significant decreased CR, elevated MI, depressed NAA, and MM09 and MM20 abnormalities.  Similar, but more severe metabolite changes were  identified in the SPMS patient group with extension of the metabolite abnormalities into the centrum semi-ovale.  

This pilot study demonstrates employment of the LC model to standardize MRS data yielding statistically significant differences between RRMS patients and controls/SPMS patients.  There is disease progression, particuarly in the centrum semi-ovale in SPMS patients when compared to RRMS patients.

LC model standarization allows for differentiation of RRMS and SPMS patients which will impact upon prognosis, and influence therapuetic descisions.

Jewells, V, Kwock, L, Markovic-Plese, S, Lee, Y, Speer, D, Feng, D, Taylor, R, et al, 0, LC Model-assisted 3T Multivoxel, Multislab MR Spectroscopy Comparison of Relapsing Remitting, and Secondary Progressive Multiple Sclerosis.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8009260.html