December 3, 2003
Researchers from New York University report that using magnetic resonance imaging (MRI), a sophisticated imaging test, can detect multiple sclerosis when it is in an early stage.
Specifically, they found that using MRI to measure the brain for levels of a chemical called N-acetylaspartate (NAA) can detect MS cases earlier and assess the severity of the disease.
The findings were presented this week at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America.
Dr. Oded Gonen and colleagues at New York University assessed NAA concentrations in scans done in 42 MS patients (30 women) who had an average six-year history of relapsing-remitting MS. The average patient age was 38 and the median Expanded Disability Status Score was 1.5.
Dr. Gonen said that "NAA levels demonstrate a steady decline that correlates with disease duration."
At a meeting press conference he said that NAA measurement will be useful both for early diagnosis of MS and as a potential way to evaluate MS treatments.
He noted that currently MS diagnosis is only made after multiple episodes, thus "early" diagnosis is not a possibility. If the findings are replicated in other studies, NAA could be used as a very early marker of disease since NAA levels begin to decline with initial onset of MS, Dr. Gonen said.
A unique aspect of Dr. Gonen's study is that it targets "the gray matter, not the white matter in the brain," explained Dr. David Yousem of Johns Hopkins University, who is a spokesperson for RSNA but was not involved in the study.
Since MS is a demyelinating disease, a disease that destroys the myelin
that coats the neurons--causing loss of function--previous imaging studies
have concentrated on white matter, Dr. Yousem noted. "This doesn't suggest
that MS is a gray matter disease -- it isn't -- but it tells us that as
the white matter is destroyed the neurons die. When they die, the NAA decreases."
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