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Patterns of multiple sclerosis (MS) plaques by magnetic resonance imaging (MRI) and proton-MR spectroscopy (1H-MRS) evaluation
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The contribution of (1)H-magnetic resonance spectroscopy in defining the pathophysiology of multiple sclerosis
No full textProton magnetic resonance spectroscopy ((1)H-MRS) is considered a suitable
investigation technique for obtaining in vivo information on pathological changes
in multiple sclerosis (MS) brain. The main betabolites identified are
choline-containing compounds, creatine, N-acetylaspartate (NAA), lactate, mobile
lipids, myo-inositol, glutamate and glutamine. Proton spectra may be acquired
from localized volumes of interest on single MS lesions or from the entire brain
by (1)H-MRS imaging. An increase of choline and lipids (markers of demyelination)
and the presence of lactate (marker of acute inflammatory reaction) have been
demonstrated in active Gd-enhancing MS plaques. A reduction of NAA (marker of
neuronal or axonal damage) has been found in inactive MS lesions. The recent
evidence of an early NAA decrease in active plaques and in normal appearing white
matter suggests that axonal damage is an early event in the evolution of
demyelinating lesions. The correlation between NAA decrease and clinical
disability conforms that axonal damage has important functional consequences, and
indicates that the prevention of irreversible axonal loss might be a major target
for the design and the timing of therapeutical strategies
Epidemiology of pediatric multiple sclerosis: incidence, prevalence and susceptibility risk factors
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