An In-vivo 1H-MRS short-echo time technique at 7T: quantification of metabolites in chronic multiple sclerosis and neuromyelitis optica brain lesions and normal appearing brain tissue

Tackley, George ORCID: https://orcid.org/0000-0002-7464-7662, Kong, Yazhuo, Minne, Rachel, Messina, Silvia, Winkler, Anderson, Cavey, Ana, Everett, Rosie, DeLuca, Gabriele C., Weir, Andrew, Craner, Matthew, Tracey, Irene, Palace, Jacqueline, Stagg, Charlotte J. and Emir, Uzay 2021. An In-vivo 1H-MRS short-echo time technique at 7T: quantification of metabolites in chronic multiple sclerosis and neuromyelitis optica brain lesions and normal appearing brain tissue. NeuroImage 238 , 118225. 10.1016/j.neuroimage.2021.118225

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Abstract

Magnetic Resonance Spectroscopy (MRS) allows for the non-invasive quantification of neurochemicals and has the potential to differentiate between the pathologically distinct diseases, multiple sclerosis (MS) and AQP4Ab-positive neuromyelitis optica spectrum disorder (AQP4Ab-NMOSD). In this study we characterised the metabolite profiles of brain lesions in 11 MS and 4 AQP4Ab-NMOSD patients using an optimised MRS methodology at ultra-high field strength (7T) incorporating correction for T2 water relaxation differences between lesioned and normal tissue. MS metabolite results were in keeping with the existing literature: total N-acetylaspartate (NAA) was lower in lesions compared to normal appearing brain white matter (NAWM) with reciprocal findings for myo-Inositol. An unexpected subtlety revealed by our technique was that total NAA differences were likely driven by NAA-glutamate (NAAG), a ubiquitous CNS molecule with functions quite distinct from NAA though commonly quantified together with NAA in MRS studies as total NAA. Surprisingly, AQP4Ab-NMOSD showed no significant differences for total NAA, NAA, NAAG or myo-Inositol between lesion and NAWM sites, nor were there any differences between MS and AQP4Ab-NMOSD for a priori hypotheses. Post-hoc testing revealed a significant correlation between NAWM Ins:NAA and disability (as measured by EDSS) for disease groups combined, driven by the AP4Ab-NMOSD group. Utilising an optimised MRS methodology, our study highlights some under-explored subtleties in MRS profiles, such as the absence of myo-Inositol concentration differences in AQP4Ab-NMOSD brain lesions versus NAWM and the potential influence of NAAG differences between lesions and normal appearing white matter in MS.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology Cardiff University Brain Research Imaging Centre (CUBRIC)
Publisher:	Elsevier
ISSN:	1053-8119
Funders:	Wellcome Trust
Date of First Compliant Deposit:	1 June 2021
Date of Acceptance:	29 May 2021
Last Modified:	26 Sep 2024 01:05
URI:	https://orca.cardiff.ac.uk/id/eprint/141666

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