Kauv Paul, Ayache Samar S, Créange Alain, Chalah Moussa A, Lefaucheur Jean-Pascal, Hodel Jérôme, Brugières Pierre
EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France.
Eur Neurol. 2017;77(5-6):316-321. doi: 10.1159/000475496. Epub 2017 May 4.
BACKGROUND/AIMS: Phosphorus magnetic resonance spectroscopy (31P-MRS) has previously shown abnormal changes in energy metabolites in the brain of multiple sclerosis (MS) patients. However, the relationship between these energy metabolites - particularly adenosine triphosphate (ATP) - and the disease severity remains unclear. The objective of this study was to determine whether measuring ATP metabolites can help to predict disease severity in MS patients.
31P-MRS at 3 tesla was performed in 9 relapsing remitting (RRMS), 9 secondary progressive MS patients (SPMS), and 10 age-matched healthy controls. ATP metabolites (expressed as %) in normally appearing white matter of the centrum semiovale were compared between patients and healthy controls. The relationship between Expanded Disability Status Scale (EDSS) and ATP metabolites was evaluated.
RRMS and SPMS patients had higher phosphocreatine (PCr) and lower phosphodiesters than healthy controls. In addition, RRMS patients had higher β-ATP% than SPMS patients. β-ATP% was negatively correlated with EDSS in all patients.
Our findings suggest a defective PCr metabolism in both patient groups, and a higher state of energy production in RRMS that might reflect a compensatory mechanism in face of the increased needs. The correlation of β-ATP with EDSS makes it a candidate biomarker for assessing MS disease severity.
背景/目的：磷磁共振波谱（31P-MRS）先前已显示多发性硬化症（MS）患者大脑中的能量代谢物存在异常变化。然而，这些能量代谢物——尤其是三磷酸腺苷（ATP）——与疾病严重程度之间的关系仍不清楚。本研究的目的是确定测量ATP代谢物是否有助于预测MS患者的疾病严重程度。
对9例复发缓解型（RRMS）、9例继发进展型MS患者（SPMS）和10例年龄匹配的健康对照者进行3特斯拉的31P-MRS检查。比较患者和健康对照者半卵圆中心正常白质中ATP代谢物（以%表示）。评估扩展残疾状态量表（EDSS）与ATP代谢物之间的关系。
RRMS和SPMS患者的磷酸肌酸（PCr）高于健康对照者，磷酸二酯低于健康对照者。此外，RRMS患者的β-ATP%高于SPMS患者。所有患者中，β-ATP%与EDSS呈负相关。
我们的研究结果表明，两组患者均存在PCr代谢缺陷，RRMS患者的能量产生状态较高，这可能反映了面对需求增加时的一种代偿机制。β-ATP与EDSS的相关性使其成为评估MS疾病严重程度的候选生物标志物。
