ArticleScientific reports2026
Metabolic changes in normal-appearing white matter associate with MRI measures of disease burden in relapsing-remitting multiple sclerosis over three years.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Myo-inositol (mI) and total N-acetylaspartate (tNAA) are potential MR spectroscopic imaging (MRSI) biomarkers of smouldering-associated worsening in multiple sclerosis (MS). In this study, we explored metabolic changes in normal-appearing white matter (NAWM) in patients with relapsing-remitting MS (pwRRMS) using 7 T MRSI. 20 pwRRMS were scanned annually with 2D-MRSI, with follow-up ranging up to three years. Metabolic ratios were calculated within NAWM for each measurement and assessed cross-sectionally and longitudinally with established and emerging MRI measures of disease burden, including paramagnetic rim lesions (PRLs), brain atrophy, and T2 lesion load. At baseline, pwRRMS showed higher mI/tNAA (β = 0.058; p = 0.047) and lower tNAA/total creatine (tCr) (β = - 0.106; p = 0.029) compared to controls. tNAA/tCr was further reduced in pwRRMS with PRLs (β = - 0.138; p = 0.022). mI/tNAA was associated negatively with cerebral WM volume (β = - 0.001, p = 0.015) and positively with T2 lesion volume (β = 0.009; p = 0.044). mI/tNAA increased longitudinally in pwRRMS (β = 0.014; p = 0.022), especially with higher PRL count (β
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