MULTIPLE-SCLEROSIS IN CHILDREN - CEREBRAL METABOLIC ALTERATIONS MONITORED BY LOCALIZED PROTON MAGNETIC-RESONANCE SPECTROSCOPY INVIVO
MULTIPLE-SCLEROSIS IN CHILDREN - CEREBRAL METABOLIC ALTERATIONS MONITORED BY LOCALIZED PROTON MAGNETIC-RESONANCE SPECTROSCOPY INVIVO
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DOI：
10.1002/ana.410320205
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发表时间：
1992-08-01
影响因子：
11.2
通讯作者：
BAUER, HJ
中科院分区：
文献类型：
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作者：
BRUHN, H;FRAHM, J;BAUER, HJ
8例已确诊多发性硬化症的儿童（7-16岁）的体内质子磁共振波谱显示与该疾病不同方面相关的区域脑代谢的明显改变：(1)与年龄匹配的对照组相比，多发性硬化症斑块的局部质子谱（2 - 4毫升感兴趣体积）通常表现为n -乙酰天冬氨酸和肌酸减少，胆碱和肌醇增加；(2)急性加重期间，慢性斑块和增强斑块（钆-二乙烯三胺五乙酸）均未显示乳酸或脂质水平升高；(3)磁共振图像中未出现可疑的邻近白质谱与正常对照相似；(4)与邻近多发性硬化症病变相关的皮质灰质显示n -乙酰天冬氨酸明显减少。目前的结果表明，多发性硬化症的功能损害与神经元细胞化学的总体代谢紊乱有关。我们认为局灶性脱髓鞘伴随着增生性转换的膜前体增加，并与继发性神经元萎缩或丧失有关，可能延伸到相关的皮质灰质。
In vivo proton magnetic resonance spectroscopy of 8 children (7-16 years) with established multiple sclerosis revealed distinct alterations in regional cerebral metabolism associated with different aspects of the disease: (1) Localized proton spectra (2 to 4-ml volumes of interest) from multiple sclerosis plaques were generally characterized by a decrease in N-acetylaspartate and creatines, and an increase in cholines and myo-inositol relative to age-matched control subjects, (2) neither chronic nor enhancing plaques (by gadolinium-diethylenetriamine pentaacetic acid) during an acute exacerbation showed elevated levels of lactate or lipids, (3) spectra from adjacent white matter that did not appear suspicious in magnetic resonance images were similar to those of normal control subjects, and (4) cortical gray matter related to neighboring multiple sclerosis lesions showed a notable reduction of N-acetylaspartate. The present results show that functional impairment in multiple sclerosis is linked to gross metabolic disturbances of neuronal cell chemistry. We suggest that focal demyelination is accompanied by increased membrane precursors of proliferative turnover and is associated with secondary neuronal shrinkage or loss, perhaps extending into related cortical gray matter.