N-acetylaspartic acid in cerebrospinal fluid of multiple sclerosis patients determined by gas-chromatography-mass spectrometryReport as inadecuate




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Journal of Neurology

, 254:631

First Online: 06 April 2007Received: 28 February 2006Revised: 11 July 2006Accepted: 25 July 2006

Abstract

BackgroundAxonal degeneration is considered to play a major role in the development of clinical disability in multiple sclerosis MS. N-AcetylAspartic Acid NAA is a neuron-specific marker constantly identified in MR-spectroscopy studies of the normal and MS brain. To our knowledge there are no studies available that evaluated NAA in cerebrospinal fluid CSF as a possible marker for disease severity.

ObjectiveTo evaluate CSF concentrations of NAA in MS in relation to disease phenotype, clinical measures of disability and MRI markers of disease burden.

MethodsNAA concentrations were determined in CSF of 46 patients with MS 26 relapsing remitting RRMS, 12 secondary progressive SPMS and 8 primary progressive PPMS. Prior to lumbar puncture, MS-patients underwent MRI and clinical examination, including the Expanded Disability Status Scale EDSS and the MS Functional Composite MSFC. Additionally, CSF concentrations of NAA were determined in 12 patients with other neurological diseases OND.

ResultsMedian CSF NAA concentration was 0.74 IQR: 0.59-.94 in RRMS , 0.54 IQR: 0.35-.73 in SPMS and 0.83 μmol-l IQR: 0.56-.03 in PPMS patients. SPMS patients had a significantly lower NAA concentration than RRMS patients. NAA concentrations correlated with EDSS r = 0.37, p = 0.016, MSFC r = 0.41, p = 0.010, normalised brain volume r = 0.49, p = 0.001, T2 lesion load r = 0.35, p = 0.021 and black hole lesion load r = 0.47, p = 0.002. No differences were observed between OND median: 0.57 IQR: 0.28-.73 and MS patients.

ConclusionCSF NAA concentration in MS patients is related to clinical performance and MRI measures of disease burden and may therefore be an important neuron specific marker of disease severity and possibly progression.

Key words N-acetylaspartic acid cerebrospinal fluid multiple sclerosis magnetic resonance imaging  Download fulltext PDF



Author: Bas Jasperse - Cornelis Jakobs - M. Judith Eikelenboom - Christine D. Dijkstra - Bernard M. J. Uitdehaag - Frederik Bark

Source: https://link.springer.com/



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