Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France/Siemens Healthineers, Saint-Denis, France.
Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France.
Mult Scler. 2019 Jan;25(1):39-47. doi: 10.1177/1352458517736146. Epub 2017 Oct 24.
Increase of brain total sodium concentrations (TSC) is present in multiple sclerosis (MS), but its pathological involvement has not been assessed yet.
To determine in vivo the metabolic counterpart of brain sodium accumulation.
MATERIALS/METHODS: Whole brain Na-MR imaging and 3D-H-EPSI data were collected in 21 relapsing-remitting multiple sclerosis (RRMS) patients and 20 volunteers. Metabolites and sodium levels were extracted from several regions of grey matter (GM), normal-appearing white matter (NAWM) and white matter (WM) T lesions. Metabolic and ionic levels expressed as Z-scores have been averaged over the different compartments and used to explain sodium accumulations through stepwise regression models.
MS patients showed significant Na accumulations with lower choline and glutamate-glutamine (Glx) levels in GM; Na accumulations with lower N-acetyl aspartate (NAA), Glx levels and higher Myo-Inositol (m-Ins) in NAWM; and higher Na, m-Ins levels with lower NAA in WM T lesions. Regression models showed associations of TSC increase with reduced NAA in GM, NAWM and T lesions, as well as higher total-creatine, and smaller decrease of m-Ins in T lesions. GM Glx levels were associated with clinical scores.
Increase of TSC in RRMS is mainly related to neuronal mitochondrial dysfunction while dysfunction of neuro-glial interactions within GM is linked to clinical scores.
脑总钠浓度（TSC）在多发性硬化症（MS）中增加，但尚未评估其病理相关性。
在体内确定脑钠积累的代谢对应物。
材料/方法：在 21 名复发缓解型多发性硬化症（RRMS）患者和 20 名志愿者中收集了全脑 Na-MR 成像和 3D-H-EPSI 数据。从灰质（GM）、正常表现白质（NAWM）和白质（WM）T 病变的几个区域提取代谢物和钠水平。以 Z 分数表示的代谢物和离子水平在不同隔室中平均化，并通过逐步回归模型用于解释钠积累。
MS 患者的 GM 中 Na 积累显著，胆碱和谷氨酸-谷氨酰胺（Glx）水平降低；NAWM 中 Na 积累，N-乙酰天冬氨酸（NAA）、Glx 水平降低，肌醇（m-Ins）水平升高；WM T 病变中 Na 水平升高，m-Ins 水平升高，NAA 水平降低。回归模型显示 TSC 增加与 GM、NAWM 和 T 病变中 NAA 减少、总肌酸增加以及 T 病变中 m-Ins 减少有关。GM Glx 水平与临床评分相关。
RRMS 中 TSC 的增加主要与神经元线粒体功能障碍有关，而 GM 中神经胶质相互作用的功能障碍与临床评分有关。
