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NEUROLOGY 2004;62:624-627
© 2004 American Academy of Neurology
Brief Communications

Neuronal cell injury precedes brain atrophy in multiple sclerosis

Y. Ge, MD, O. Gonen, PhD, M. Inglese, MD, J. S. Babb, PhD, C. E. Markowitz, MD and R. I. Grossman, MD

From the Department of Radiology (Drs. Ge, Gonen, Inglese, Babb, and Grossman), New York University School of Medicine, New York, NY; and Department of Neurology (Dr. Markowitz), University of Pennsylvania Medical Center, Philadelphia, PA.

Address correspondence and reprints request to Dr. Oded Gonen, Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY 10016; e-mail: oded.gonen{at}med.nyu.edu

Global brain atrophy estimated using MRI and whole brain N-acetylaspartate (WBNAA) concentration measured with proton MR spectroscopy were obtained in 42 patients with relapsing-remitting multiple sclerosis and 41 matched control subjects. Patients exhibited cross-sectional atrophy (0.5%; p = 0.033) and WBNAA decline (1.8%/y; p = 0.005) vs disease duration. The 3.6-fold rate disparity between the two processes suggests that neuronal/axonal dysfunction (N-acetylaspartate decline) precedes parenchyma loss, not its consequence (i.e., is an earlier, more sensitive specific metric of the ongoing disease activity).

Received April 24, 2003. Accepted in final form August 26, 2003.




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Correspondence:

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Neuronal cell injury precedes brain atrophy in multiple sclerosis
John A. Kamholz, et al.
Neurology Online, 15 Jul 2004 [Full text]
Reply to Kamholz et al
Oded Gonen, MD
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