Diffuse Subclinical Disease Activity in Normal-Appearing White Matter During Remission in Multiple Sclerosis: A Proton MR Spectroscopy Study

Ivan I. Kirov¹, Vishal Patil¹, James Babb¹, Henry Rusinek¹, Joseph Herbert², Oded Gonen¹

To test the hypothesis that widespread chronic pathogenesis precedes axonal damage in MRI normal-appearing tissue in relapsing-remitting MS, we used 3D proton MR spectroscopy at 3 T to quantify the concentrations of NAA, Cr, Cho and mI in a 360 cm³ volume of interest (VOI) about the corpus callosum (mostly white matter). Twenty-one recently diagnosed mildly disabled patients and 15 matched controls were enrolled. The results reveal that patients VOI tissue volume fraction and NAA concentration were not different from controls. In contrast, the patients Cr, Cho and mI levels were 9%, 14% and 20%, higher than the controls.