Sarchielli P, Presciutti O, Pelliccioli G P, Tarducci R, Gobbi G, Chiarini P, Alberti A, Vicinanza F, Gallai V
Neurologic Clinic, University of Perugia, Italy.
Brain. 1999 Mar;122 ( Pt 3):513-21. doi: 10.1093/brain/122.3.513.
The aim of this research was to obtain an absolute quantification of the N-acetyl-aspartate, choline, creatine and phosphocreatine levels in normal-appearing white matter by means of 1H magnetic resonance spectroscopy in a group of multiple sclerosis patients (27 with the relapsing-remitting form and 13 with the secondary progressive form). These values were compared with those of a group of 12 age-matched healthy control subjects. A significant decrease in the N-acetyl-aspartate concentration was found in normal-appearing white matter of frontal and parietal brain areas in multiple sclerosis patients compared with the same areas in control subjects. This reduction was more evident in progressive patients. The decrease in the N-acetyl-aspartate concentration in normal-appearing white matter significantly correlated with the Expanded Disability Status and the lesional load. No significant change was found in the concentration of creatine or choline. This finding concurs with previous evidence of heterogeneity in the multiple sclerosis pathological process which is not confined to the lesions and involves not only myelin, but also axons, even in white matter which appears normal on MRI.
本研究的目的是通过氢质子磁共振波谱法对一组多发性硬化症患者（27例复发缓解型和13例继发进展型）正常白质中的N-乙酰天门冬氨酸、胆碱、肌酸和磷酸肌酸水平进行绝对定量分析。将这些值与一组12名年龄匹配的健康对照受试者的值进行比较。与对照受试者相同脑区相比，多发性硬化症患者额叶和顶叶脑区正常白质中的N-乙酰天门冬氨酸浓度显著降低。这种降低在进展型患者中更为明显。正常白质中N-乙酰天门冬氨酸浓度的降低与扩展残疾状态和病灶负荷显著相关。肌酸或胆碱的浓度未发现显著变化。这一发现与先前关于多发性硬化症病理过程异质性的证据一致，该异质性不仅局限于病灶，不仅涉及髓鞘，还涉及轴突，即使在MRI上看似正常的白质中也是如此。
