Abstract #1850

Cross sectional evaluation of neurometabolic alterations in RRMS with fingolimod and injectable treatments using advanced MRS

Oun Al-iedani^1,2, Karen Ribbons², Saadallah Ramadan^1,2, Rodney Lea², and Jeannette Lechner-Scott^2,3,4

¹School of Health Sciences, University of Newcastle, Newcastle, Australia, ²Hunter Medical Research Institute (HMRI), Newcastle, Australia, ³School of Medicine and Public Health, University of Newcastle, Newcastle, Australia, ⁴Department of Neurology, John Hunter Hospital, Newcastle, Australia

This novel study evaluated the amount of axonal injury with neurometabolite in RRMS patients on fingolimod(N=52) and injectable(N=46) treatments compared with 51 HCs in hippocampus using advanced MRS. PRESS-MRS of the hippocampal voxel(30x15x15mm3) and clinical assessments for RRMS and HCs were acquired. Hippocampal MR-spectra were analysed by LCModel. Hippocampal-NAA/tCr decreased (fingolimod:-17%,p=0.001;injectables:-15%,p=0.01) and in Glx/tCr increased (fingolimod:+16%,p=0.001;injectables:+15%,p=0.02) in RRMS compared to HCs. Total-ARCS (r=0.402) and memory in particular (r=0.428) displayed associations with hippocampal NAA/tCr. This study is the first cross-sectional in-vivo investigation comparing the impact of fingolimod and injectable treatments on the hippocampal metabolism in RRMS patients.

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