Normal-appearing White Matter N-acetylaspartate Changes in Multiple Sclerosis as a Potential Biomarker

The use of an accessible and quantifiable biomarker provides an opportunity for research and monitoring of multiple sclerosis. The aim of the present study was to assess potential changes in N-acetylaspartate, creatine and choline levels in normal-appearing white matter and to investigate the sex-related distribution of these metabolites in relapsing remitting multiple sclerosis. A total of 50 patients and 28 healthy controls were studied. Corresponding normal-appearing regions of white matter were examined by proton magnetic resonance spectroscopy in all participants. We were able to establish elevated levels of N-acetylaspartate, choline and creatine in the patients' group. The statistical analysis showed that there were significant differences in creatine levels between the two groups, whereas N-acetylaspartate demonstrated significantly higher PrMRS peaks in male RRMS subjects. The results obtained during our study by PrMRS established metabolic changes in NAWM. We need to look at the underlying pathological process which is leading to demyelinating plaques. The gender impact also requires further investigation, and it can be inferred that PrMRS provides quantifiable measurement with characteristics of a potential biomarker.