Muhlert Nils, Atzori Matteo, De Vita Enrico, Thomas David L, Samson Rebecca S, Wheeler-Kingshott Claudia A M, Geurts Jeroen J G, Miller David H, Thompson Alan J, Ciccarelli Olga
Department of Neuroinflammation, NMR Research Unit, UCL Institute of Neurology, London, UK Cognitive Neuroscience, Department of Psychology, Cardiff University, Cardiff, UK.
Department of Brain Repair and Rehabilitation, NMR Research Unit, UCL Institute of Neurology, London, UK Department of Neurology, University of Padova, Padova, Italy.
J Neurol Neurosurg Psychiatry. 2014 Aug;85(8):833-9. doi: 10.1136/jnnp-2013-306662. Epub 2014 Jan 15.
Glutamate is the principal excitatory neurotransmitter and is involved in normal brain function. Cognitive impairment is common in multiple sclerosis (MS), and understanding its mechanisms is crucial for developing effective treatments. We used structural and metabolic brain imaging to test two hypotheses: (i) glutamate levels in grey matter regions are abnormal in MS, and (ii) patients show a relationship between glutamate concentration and memory performance.
Eighteen patients with relapsing-remitting MS and 17 healthy controls were cognitively assessed and underwent (1)H-magnetic resonance spectroscopy at 3 T to assess glutamate levels in the hippocampus, thalamus, cingulate and parietal cortices. Regression models investigated the association between glutamate concentration and memory performance independently of magnetisation transfer ratio values and grey matter lesions withint he same regions, and whole-brain grey matter volume.
Patients had worse visual and verbal memory than controls. A positive relationship between glutamate levels in the hippocampal, thalamic and cingulate regions and visuospatial memory was detected in patients, but not in healthy controls.
The relationship between memory and glutamate concentration, which is unique to MS patients, suggests the reliance of memory on glutamatergic systems in MS.
谷氨酸是主要的兴奋性神经递质，参与大脑的正常功能。认知障碍在多发性硬化症（MS）中很常见，了解其机制对于开发有效的治疗方法至关重要。我们使用脑结构和代谢成像来检验两个假设：（i）MS患者灰质区域的谷氨酸水平异常，以及（ii）患者的谷氨酸浓度与记忆表现之间存在关联。
对18例复发缓解型MS患者和17名健康对照者进行认知评估，并在3 T条件下进行氢磁共振波谱分析，以评估海马体、丘脑、扣带回和顶叶皮质中的谷氨酸水平。回归模型独立于同一区域内的磁化传递率值和灰质病变以及全脑灰质体积，研究了谷氨酸浓度与记忆表现之间的关联。
患者的视觉和言语记忆比对照者差。在患者中检测到海马体、丘脑和扣带回区域的谷氨酸水平与视觉空间记忆之间存在正相关，但在健康对照者中未检测到。
MS患者特有的记忆与谷氨酸浓度之间的关系表明，MS患者的记忆依赖于谷氨酸能系统。
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