Metabolic counterparts of sodium accumulation in multiple sclerosis: A whole brain 23 Na-MRI and fast 1 H-MRSI study

Maxime Donadieu, Yann Le Fur, Adil Maarouf, Soraya Gherib, Ben Ridley, Lauriane Pini, Stanislas Rapacchi, Sylviane Confort-Gouny, Maxime Guye, Lothar R. Schad, Andrew A. Maudsley, Jean Pelletier, Bertrand Audoin, Wafaa Zaaraoui, Jean Philippe Ranjeva

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Increase of brain total sodium concentrations (TSC) is present in multiple sclerosis (MS), but its pathological involvement has not been assessed yet. Objective: To determine in vivo the metabolic counterpart of brain sodium accumulation. Materials/methods: Whole brain 23 Na-MR imaging and 3D- 1 H-EPSI data were collected in 21 relapsing-remitting multiple sclerosis (RRMS) patients and 20 volunteers. Metabolites and sodium levels were extracted from several regions of grey matter (GM), normal-appearing white matter (NAWM) and white matter (WM) T 2 lesions. Metabolic and ionic levels expressed as Z-scores have been averaged over the different compartments and used to explain sodium accumulations through stepwise regression models. Results: MS patients showed significant 23 Na accumulations with lower choline and glutamate–glutamine (Glx) levels in GM; 23 Na accumulations with lower N-acetyl aspartate (NAA), Glx levels and higher Myo-Inositol (m-Ins) in NAWM; and higher 23 Na, m-Ins levels with lower NAA in WM T 2 lesions. Regression models showed associations of TSC increase with reduced NAA in GM, NAWM and T 2 lesions, as well as higher total-creatine, and smaller decrease of m-Ins in T 2 lesions. GM Glx levels were associated with clinical scores. Conclusion: Increase of TSC in RRMS is mainly related to neuronal mitochondrial dysfunction while dysfunction of neuro-glial interactions within GM is linked to clinical scores.

Original languageEnglish (US)
Pages (from-to)39-47
Number of pages9
JournalMultiple Sclerosis Journal
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • MRSI
  • Na-MRI
  • demyelination
  • multiple sclerosis
  • neurodegeneration
  • stepwise regression

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Donadieu, M., Le Fur, Y., Maarouf, A., Gherib, S., Ridley, B., Pini, L., Rapacchi, S., Confort-Gouny, S., Guye, M., Schad, L. R., Maudsley, A. A., Pelletier, J., Audoin, B., Zaaraoui, W., & Ranjeva, J. P. (2019). Metabolic counterparts of sodium accumulation in multiple sclerosis: A whole brain 23 Na-MRI and fast 1 H-MRSI study. Multiple Sclerosis Journal, 25(1), 39-47. https://doi.org/10.1177/1352458517736146