Assessment of normal-appearing brain white matter in patients with optic neuritis and multiple sclerosis by magnetic resonance spectroscopy

Abstract

Background Multiple sclerosis (MS) is an inflammatory, demyelinating, and neurodegenerative disease of the central nervous system, characterized pathologically by disseminated areas of demyelination and variable degrees of axonal loss and glial scarring. Typical optic neuritis may be associated with MS and is the most common type of optic neuritis. Nonconventional MRI such as magnetic resonance spectroscopy (MRS) has been used to enhance our knowledge of the pathophysiology of MS. Objectives To evaluate metabolic changes of brain normal-appearing white matter among patients either presented with optic neuritis alone or those already diagnosed as having MS. Patients and methods This is a cross-sectional study that was carried out on 30 patients with MS and 30 patients with typical optic neuritis attending neurology MS clinic of Al Azhar University Hospitals. All patients were subjected to the following: detailed history talking, assessment of disease severity by the Expanded Disability Status Scale, routine laboratory investigations, radiological evaluation (MS protocol), and MRS. Results The results of the study revealed significant metabolic changes by MRS in patients with optic neuritis and MS. Conclusion MRS provides advanced insights into the pathogenesis of optic neuritis and MS by obtaining information on the microenvironment within the brain. This enhances the understanding of the mechanisms involved in disease progression. MRS opens a window to detect early conversion of patient of the typical optic neuritis into MS.