Daniel J. Rigotti1, Lutz Achtnichts2, Oded Gonen1, James S. Babb1, Yvonne Naegelin2, Kerstin Bendtfield2, Jochen Hirsch2, Michael Amann2, Robert I. Grossman1, Ludwig Kapposs2, Achim Gass2
1Radiology, New York University School of Medicine, New York, NY, United States; 2Neurology & Neuroradiology, University Hospital Basel, Basel, Switzerland
The need for reliable criteria to identify multiple sclerosis patients who will remain clinically benign over the long term and the link between neural damage and disability prompted us to test whether benign patients suffer less global neuronal injury than their more disabled contemporaries. We analyzed the global concentration of N-acetylaspartate (WBNAA), a marker for diffuse neurodegeneration, in clinically benign and non-benign patients and show that there is indeed no difference in neural sparing. The clinical disparity of the two groups, therefore, can be explained by insufficient clinical descriptors of phenotype as well as different brain plasticity and lesion evolution.