Martínez-Bisbal M C, Celda B, Martí-Bonmat L, Casanova-Estruch B, Coret-Ferrer F
Departamento de Química-Física, Universidad de Valencia. Facultad de Psicología, Burjassot, 46100, España.
Rev Neurol. 2002;34(9):807-12.
Multiple sclerosis (MS) is a chronic demyelinating disorder of the central nervous system, characterized by the presence of inflammatory lesions.
To analyze the biochemical profile of the demyelinating lesions of the initial forms of MS (remitting relapsing) by analyzing the proton magnetic resonance spectra (1H MRS) to characterize the process of demyelination and relate it to the metabolites and clinical variables analyzed.
We analyzed the largest demyelinating lesions in eight patients with remitting relapsing MS (RRMS) using the technique of single volume 1H MRS (VOI) with short echo time. The spectra of the white matter of two healthy control were used as reference.
NAA/Cr and NAA/Cho value ratios decrease and mI/Cr one increase in all spectra lesions as compared to healthy controls. In four of the eight patients, the Cho/Cr was higher than in the controls. Qualitative and quantitative differences in the resonances of macromolecules were observed, related to the biochemistry of the process of demyelination. These differences in NAA/Cr, Cho/Cr, mI/Cr and macromolecules probably represent different stages in the evolution of the plaques.
MRS is a non invasive technique able to observe biochemical variations related to the evolution process of demyelination. Activity of the lesion is shown by the increment of resonances around 0.9 1.3 ppm. An increase in mI seems to occur at an early stage of demyelination and later the NAA is reduced. The initial forms of MS show metabolic alterations in the plaques which are similar to the most advanced forms of MS.
多发性硬化症（MS）是一种中枢神经系统的慢性脱髓鞘疾病，其特征为存在炎性病变。
通过分析质子磁共振波谱（1H MRS）来分析MS初始形式（复发缓解型）脱髓鞘病变的生化特征，以表征脱髓鞘过程，并将其与所分析的代谢物和临床变量相关联。
我们使用短回波时间的单容积1H MRS（VOI）技术分析了8例复发缓解型MS（RRMS）患者中最大的脱髓鞘病变。将两名健康对照者白质的波谱用作参考。
与健康对照相比，所有波谱病变中的NAA/Cr和NAA/Cho值比率降低，mI/Cr值升高。8例患者中有4例的Cho/Cr高于对照。观察到大分子共振的定性和定量差异，这与脱髓鞘过程的生物化学有关。NAA/Cr、Cho/Cr、mI/Cr和大分子的这些差异可能代表斑块演变的不同阶段。
MRS是一种能够观察与脱髓鞘演变过程相关的生化变化的非侵入性技术。病变的活性通过0.9至1.3 ppm附近共振的增加来显示。mI的增加似乎发生在脱髓鞘的早期，随后NAA降低。MS的初始形式在斑块中显示出与MS最晚期形式相似的代谢改变。
