De Stefano N, Matthews P M, Narayanan S, Francis G S, Antel J P, Arnold D L
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, PQ, Canada.
Neurology. 1997 Oct;49(4):1138-41. doi: 10.1212/wnl.49.4.1138.
In a 6-year longitudinal study of a patient with relapsing progressive multiple sclerosis (MS), we used proton magnetic resonance spectroscopy to assess N-acetylaspartate (NAA) from a large central brain volume to evaluate the relationship between this marker of neuronal integrity and clinical disability. During the follow-up period, there was one major relapse and its subsequent partial remission. Changes in the brain NAA to creatine ratio correlated strongly with clinical disability (Spearman rank coefficient = -0.73, p < 0.001). We interpret this as evidence that axonal dysfunction or loss contributes to functional impairment of patients with MS. Because the NAA signal in the large volume of interest originated predominantly from white matter that appeared normal on conventional MRI, these results also suggest that some degree of axonal dysfunction may be widespread in acute, severe relapses.
在一项针对复发缓解型多发性硬化症（MS）患者的6年纵向研究中，我们使用质子磁共振波谱技术从大脑中央的一个大容积区域评估N-乙酰天门冬氨酸（NAA），以评估这种神经元完整性标志物与临床残疾之间的关系。在随访期间，出现了一次严重复发及其随后的部分缓解。大脑NAA与肌酸比值的变化与临床残疾密切相关（斯皮尔曼等级系数=-0.73，p<0.001）。我们将此解释为轴突功能障碍或丢失导致MS患者功能损害的证据。由于感兴趣的大容积区域中的NAA信号主要源自常规MRI上显示正常的白质，这些结果还表明，在急性、严重复发中，一定程度的轴突功能障碍可能普遍存在。
