Cerebral white matter blood flow and energy metabolism in multiple sclerosis

Mult Scler. 2013 Sep;19(10):1282-9. doi: 10.1177/1352458513477228. Epub 2013 Feb 21.

Abstract

Background: Cerebral blood flow (CBF) is reduced in normal-appearing white matter (NAWM) of subjects with multiple sclerosis (MS), but the underlying mechanism is unknown.

Objective: The objective of this article is to assess the relationship between reduced NAWM CBF and both axonal mitochondrial metabolism and astrocytic phosphocreatine (PCr) metabolism.

Methods: Ten healthy controls and 25 MS subjects were studied with 3 Tesla magnetic resonance imaging. CBF was measured using pseudo-continuous arterial spin labeling. N-acetylaspartate/creatine (NAA/Cr) ratios (axonal mitochondrial metabolism) were obtained using (1)H-MR spectroscopy and PCr/β-ATP ratios using (31)P-MR spectroscopy. In centrum semiovale NAWM, we assessed correlations between CBF and both NAA/Cr and PCr/β-ATP ratios.

Results: Subjects with MS had a widespread reduction in CBF of NAWM (centrum semiovale, periventricular, frontal and occipital), and gray matter (frontoparietal cortex and thalamus). Compared to controls, NAA/Cr in NAWM of the centrum semiovale of MS subjects was decreased, whereas PCr/β-ATP was increased. We found no correlations between CBF and PCr/β-ATP. CBF and NAA/Cr correlated in controls (p = 0.02), but not in MS subjects (p = 0.68).

Conclusions: Our results suggest that in MS patients there is no relationship between reduced CBF in NAWM and impaired axonal mitochondrial metabolism or astrocytic PCr metabolism.

Keywords: Multiple sclerosis; N-acetylaspartate; arterial spin labeling; cerebral blood flow; magnetic resonance spectroscopy; phosphocreatine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / blood supply*
  • Brain / pathology
  • Cerebrovascular Circulation
  • Electron Spin Resonance Spectroscopy
  • Energy Metabolism / physiology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mitochondria / metabolism
  • Multiple Sclerosis / metabolism
  • Multiple Sclerosis / physiopathology*
  • Nerve Fibers, Myelinated / metabolism*
  • Spin Labels

Substances

  • Spin Labels