Topographical mapping of metabolic abnormalities in multiple sclerosis using rapid echo-less 3D-MR spectroscopic imaging at 7T
Eva Niess,
Assunta Dal-Bianco,
Bernhard Strasser,
Fabian Niess,
Lukas Hingerl,
Beata Bachrata,
Stanislav Motyka,
Paulus Rommer,
Siegfried Trattnig,
Wolfgang Bogner
Affiliations
Eva Niess
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Corresponding author at: High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14/BT32, A-1090, Vienna, Austria.
Assunta Dal-Bianco
Department of Neurology, Medical University of Vienna, Vienna, Austria
Bernhard Strasser
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
Fabian Niess
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
Lukas Hingerl
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
Beata Bachrata
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria; Karl Landsteiner Institute for Clinical Molecular MR in Musculoskeletal Imaging, Vienna, Austria
Stanislav Motyka
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for MR Imaging Biomarkers (BIOMAK), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
Paulus Rommer
Department of Neurology, Medical University of Vienna, Vienna, Austria
Siegfried Trattnig
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute for Clinical Molecular MR in Musculoskeletal Imaging, Vienna, Austria
Wolfgang Bogner
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for MR Imaging Biomarkers (BIOMAK), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
Objectives: To assess topographical patterns of metabolic abnormalities in the cerebrum of multiple sclerosis (MS) patients and their relationship to clinical disability using rapid echo-less 3D-MR spectroscopic imaging (MRSI) at 7T. Materials and Methods: This study included 26 MS patients (13 women; median age 34) and 13 age- and sex-matched healthy controls (7 women; median age 33). Metabolic maps were obtained using echo-less 3D-MRSI at 7T with a 64 × 64 × 33 matrix and a nominal voxel size of 3.4 × 3.4 × 4 mm³ in an 8-minute scan. After spatial normalization, voxel-wise comparisons between MS and controls were conducted to identify clusters of metabolic abnormalities, while correlations with clinical disability were analyzed using Expanded Disability Status Scale (EDSS) scores. Results: Statistical mapping (FWE-corrected; P<.05) revealed elevated myo-inositol to total creatine (mI/tCr) ratios in the bilateral periventricular white matter and reduced N-acetylaspartate to total creatine (NAA/tCr) within and beyond lesions, notably near the lateral ventricles, cingulate gyrus, and superior frontal gyrus. Patients with sustained disability (EDSS≥2) showed additional reductions in the posterior parietal lobe. A strong negative association was found between NAA/tCr and EDSS in the precentral gyrus (Spearman's rank ρ=-0.58, P=.005), and a moderate positive association between mI/NAA and EDSS in the precentral and superior frontal gyri (ρ=0.47, P=.015). Conclusions: This study highlights the ability of 3D-MRSI at 7T to map widespread metabolic abnormalities in MS, with NAA reductions in prefrontal, motor, and sensory areas, linked to neuroaxonal damage and disability progression, and elevated mI in periventricular regions, reflecting gliosis.
