ABSTRACT

Objectives

Multiple sclerosis (MS) is an inflammatory demyelinating disease that may cause physical disabling as well as cognitive dysfunction. The presented study investigated how the neuropsychological status depends on the thalamus and hippocampus’s metabolic processes, using γ-aminobutyric acid-edited magnetic resonance spectroscopy (GABA-edited ¹H MRS) in patients with early MS, and how the results differ from healthy volunteers.

Methods

We recruited 36 relapsing-remitting (RRMS) MS patients and 22 controls (CON). In addition to common ¹H MRS metabolites, such as N-acetyl-aspartate (tNAA), myoinositol (mIns), total choline and creatine (tCr, tCho), we also evaluated GABA and glutamate/glutamine (Glx). Metabolite ratios were correlated with the results of Single-Digit Modality Test (SDMT) and Expanded Disability Status Score (EDSS).

Results

In the thalamus, GABA ratios (GABA/tCr, GABA/tNAA) were significantly lower in RRMS patients than in CON. Both tCho- and mIns-ratios correlated with lower scores of SDMT but not with EDSS. Metabolic ratios in the hippocampus did not differ between RRMS and CON and did not correlate with any of performed tests.

Discussion

This study is the first to provide GABA-edited ¹H MRS evidence for MS-related metabolic changes of the thalamus and hippocampus. The findings underline the importance of evaluating subcortical grey matter in MS patients to improve understanding of the clinical manifestations of MS and as a potential future target for treatment.

中文翻译：

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复发缓解型多发性硬化症患者的神经认知表现与丘脑代谢异常有关，但与海马体无关——GABA 编辑的 1H MRS 研究

摘要

目标

多发性硬化症 (MS) 是一种炎症性脱髓鞘疾病，可能导致身体残疾和认知功能障碍。本研究使用 γ-氨基丁酸编辑的磁共振波谱（GABA 编辑的¹ H MRS）研究了早期 MS 患者的神经心理状态如何依赖于丘脑和海马的代谢过程，以及结果与健康志愿者有何不同。

方法

我们招募了 36 名复发缓解型 (RRMS) MS 患者和 22 名对照 (CON)。除了常见的¹ H MRS 代谢物，如 N-乙酰天冬氨酸 (tNAA)、肌醇 (mIns)、总胆碱和肌酸 (tCr, tCho)，我们还评估了 GABA 和谷氨酸/谷氨酰胺 (Glx)。代谢物比率与单数模态测试 (SDMT) 和扩展残疾状态评分 (EDSS) 的结果相关。

结果

在丘脑中，RRMS 患者的 GABA 比率（GABA/tCr、GABA/tNAA）显着低于 CON。tCho 和 mins 比率都与较低的 SDMT 分数相关，但与 EDSS 无关。RRMS 和 CON 之间的海马代谢比率没有差异，并且与任何执行的测试无关。

讨论

本研究首次为 MS 相关的丘脑和海马代谢变化提供 GABA 编辑的^{1 H MRS 证据。}这些发现强调了评估 MS 患者皮质下灰质以提高对 MS 临床表现的理解以及作为未来潜在治疗目标的重要性。