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Journal of Neurology
Published in: Journal of Neurology 5/2007

Open Access 01-05-2007 | ORIGINAL COMMUNICATION

N-acetylaspartic acid in cerebrospinal fluid of multiple sclerosis patients determined by gas-chromatography-mass spectrometry

Authors: Bas Jasperse, MD, Cornelis Jakobs, PhD, M. Judith Eikelenboom, MD, Christine D. Dijkstra, MD, PhD, Bernard M. J. Uitdehaag, MD, PhD, Frederik Barkhof, MD, PhD, Chris H. Polman, MD, PhD, Charlotte E. Teunissen, PhD

Published in: Journal of Neurology | Issue 5/2007

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Abstract

Background

Axonal degeneration is considered to play a major role in the development of clinical disability in multiple sclerosis (MS). N-AcetylAspartic Acid (NAA) is a neuron-specific marker constantly identified in MR-spectroscopy studies of the normal and MS brain. To our knowledge there are no studies available that evaluated NAA in cerebrospinal fluid (CSF) as a possible marker for disease severity.

Objective

To evaluate CSF concentrations of NAA in MS in relation to disease phenotype, clinical measures of disability and MRI markers of disease burden.

Methods

NAA concentrations were determined in CSF of 46 patients with MS (26 relapsing remitting (RRMS), 12 secondary progressive (SPMS) and 8 primary progressive (PPMS)). Prior to lumbar puncture, MS-patients underwent MRI and clinical examination, including the Expanded Disability Status Scale (EDSS) and the MS Functional Composite (MSFC). Additionally, CSF concentrations of NAA were determined in 12 patients with other neurological diseases (OND).

Results

Median CSF NAA concentration was 0.74 (IQR: 0.59-.94) in RRMS , 0.54 (IQR: 0.35-.73) in SPMS and 0.83 μmol/l (IQR: 0.56-.03) in PPMS patients. SPMS patients had a significantly lower NAA concentration than RRMS patients. NAA concentrations correlated with EDSS (r = )0.37, p = 0.016), MSFC (r = 0.41, p = 0.010), normalised brain volume (r = 0.49, p = 0.001), T2 lesion load (r = )0.35, p = 0.021) and black hole lesion load (r = )0.47, p = 0.002). No differences were observed between OND (median: 0.57 IQR: 0.28-.73) and MS patients.

Conclusion

CSF NAA concentration in MS patients is related to clinical performance and MRI measures of disease burden and may therefore be an important neuron specific marker of disease severity and possibly progression.
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Metadata
Title
N-acetylaspartic acid in cerebrospinal fluid of multiple sclerosis patients determined by gas-chromatography-mass spectrometry
Authors
Bas Jasperse, MD
Cornelis Jakobs, PhD
M. Judith Eikelenboom, MD
Christine D. Dijkstra, MD, PhD
Bernard M. J. Uitdehaag, MD, PhD
Frederik Barkhof, MD, PhD
Chris H. Polman, MD, PhD
Charlotte E. Teunissen, PhD
Publication date
01-05-2007
Publisher
Steinkopff-Verlag
Published in
Journal of Neurology / Issue 5/2007
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-006-0415-5

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