Open Access

Early metabolic alterations in the normal‑appearing grey and white matter of patients with clinically isolated syndrome suggestive of multiple sclerosis: A proton MR spectroscopic study

  • Authors:
    • Dimitrios Tzanetakos
    • Andreas Kyrozis
    • Efstratios Karavasilis
    • Georgios Velonakis
    • John S. Tzartos
    • Panagiotis Toulas
    • Stefania Alexia Sotirli
    • Ioannis Evdokimidis
    • Georgios Tsivgoulis
    • Constantin Potagas
    • Costantinos Kilidireas
    • Elisabeth Andreadou
  • View Affiliations

  • Published online on: May 30, 2023     https://doi.org/10.3892/etm.2023.12048
  • Article Number: 349
  • Copyright: © Tzanetakos et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Proton magnetic resonance spectroscopy (1H‑MRS) is an advanced method of examining metabolic profiles. The present study aimed to assess in vivo metabolite levels in areas of normal‑appearing grey (thalamus) and white matter (centrum semiovale) using 1H‑MRS in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis and compare them to healthy controls (HCs). Data from 35 patients with CIS (CIS group), of which 23 were untreated (CIS‑untreated group) and 12 were treated (CIS‑treated group) with disease‑modifying‑therapies (DMTs) at the time of 1H‑MRS, and from 28 age‑ and sex‑matched HCs were collected using a 3.0 T MRI and single‑voxel 1H‑MRS (point resolved spectroscopy sequence; repetition time, 2,000 msec; time to echo, 35 msec). Concentrations and ratios of total N‑acetyl aspartate (tNAA), total creatine (tCr), total choline (tCho), myoinositol, glutamate (Glu), glutamine (Gln), Glu + Gln (Glx) and glutathione (Glth) were estimated in the thalamic‑voxel (th) and centrum semiovale‑voxel (cs). For the CIS group, the median duration from the first clinical attack to 1H‑MRS was 102 days (interquartile range, 89.5.‑131.5). Compared with HCs, significantly lower Glx(cs) (P=0.014) and ratios of tCho/tCr(th) (P=0.026), Glu/tCr(cs) (P=0.040), Glx/tCr(cs) (P=0.004), Glx/tNAA(th) (P=0.043) and Glx/tNAA(cs) (P=0.015) were observed in the CIS group. No differences in tNAA levels were observed between the CIS and the HC groups; however, tNAA(cs) was higher in the CIS‑treated than in the CIS‑untreated group (P=0.028). Compared with those in HC group, decreased Glu(cs) (P=0.019) and Glx(cs) levels (P=0.014) and lower ratios for tCho/tCr(th) (P=0.015), Gln/tCr(th) (P=0.004), Glu/tCr(cs) (P=0.021), Glx/tCr(th) (P=0.041), Glx/tCr(cs) (P=0.003), Glx/tNAA(th) (P=0.030) and Glx/tNAA(cs) (P=0.015) were found in the CIS‑untreated group. The present findings showed alterations in the normal‑appearing grey and white matter of patients with CIS; moreover, the present results suggested an early indirect treatment effect of DMTs on the brain metabolic profile of these patients.
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July-2023
Volume 26 Issue 1

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Spandidos Publications style
Tzanetakos D, Kyrozis A, Karavasilis E, Velonakis G, Tzartos JS, Toulas P, Sotirli S, Evdokimidis I, Tsivgoulis G, Potagas C, Potagas C, et al: Early metabolic alterations in the normal‑appearing grey and white matter of patients with clinically isolated syndrome suggestive of multiple sclerosis: A proton MR spectroscopic study. Exp Ther Med 26: 349, 2023
APA
Tzanetakos, D., Kyrozis, A., Karavasilis, E., Velonakis, G., Tzartos, J.S., Toulas, P. ... Andreadou, E. (2023). Early metabolic alterations in the normal‑appearing grey and white matter of patients with clinically isolated syndrome suggestive of multiple sclerosis: A proton MR spectroscopic study. Experimental and Therapeutic Medicine, 26, 349. https://doi.org/10.3892/etm.2023.12048
MLA
Tzanetakos, D., Kyrozis, A., Karavasilis, E., Velonakis, G., Tzartos, J. S., Toulas, P., Sotirli, S., Evdokimidis, I., Tsivgoulis, G., Potagas, C., Kilidireas, C., Andreadou, E."Early metabolic alterations in the normal‑appearing grey and white matter of patients with clinically isolated syndrome suggestive of multiple sclerosis: A proton MR spectroscopic study". Experimental and Therapeutic Medicine 26.1 (2023): 349.
Chicago
Tzanetakos, D., Kyrozis, A., Karavasilis, E., Velonakis, G., Tzartos, J. S., Toulas, P., Sotirli, S., Evdokimidis, I., Tsivgoulis, G., Potagas, C., Kilidireas, C., Andreadou, E."Early metabolic alterations in the normal‑appearing grey and white matter of patients with clinically isolated syndrome suggestive of multiple sclerosis: A proton MR spectroscopic study". Experimental and Therapeutic Medicine 26, no. 1 (2023): 349. https://doi.org/10.3892/etm.2023.12048