MR spectroscopic evidence for thalamic and hippocampal, but not cortical, damage in multiple sclerosis

Magn Reson Med. 2006 Mar;55(3):478-83. doi: 10.1002/mrm.20792.


Gray matter (GM) damage is an important pathophysiological feature in Multiple Sclerosis (MS), and may be related to clinical, including cognitive, deficits. Quantitative single-voxel (1)H-Magnetic Resonance Spectroscopy (TR/TE 6000/20 ms) was performed in 33 MS patients (11 per disease subtype; mean age 48 years, 16 females) and 10 healthy controls (mean age 43 years, 7 females). No overall spectroscopic changes were found in MS cortex. In MS thalamus, a 9% decrease of N-acetyl aspartate (NAA; P=0.005) and a 31% increase of myo-inositol (Ins; P=0.002) were found. A 21% Ins increase was observed (P=0.02) in MS hippocampus. Reduced NAA and increased Ins concentrations are thought to reflect neuro-axonal damage or loss and gliosis, respectively. Significant correlations between Ins concentrations and total-brain T(2) lesion load were found for MS thalamus (r=0.65, P<0.001) and hippocampus (r=0.57, P=0.001). MS thalamic and hippocampal Ins concentrations also correlated with each other (r=0.68; P<0.001). Cortical Gln correlated with thalamic NAA (r=-0.38; P=0.03) in MS. Thalamic and hippocampal Ins increases were most prominent in secondary-progressive (SP) patients (37% and 34%, respectively), whereas the largest thalamic NAA decrease (14%) was found in primary-progressive (PP) patients. In conclusion, thalamic and hippocampal GM pathology are important features of (progressive) MS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / analysis
  • Cerebral Cortex / chemistry*
  • Cerebral Cortex / pathology
  • Female
  • Hippocampus / chemistry*
  • Hippocampus / pathology
  • Humans
  • Inositol / analysis
  • Magnetic Resonance Spectroscopy*
  • Middle Aged
  • Multiple Sclerosis / metabolism*
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / physiopathology
  • Thalamus / chemistry*
  • Thalamus / pathology


  • Aspartic Acid
  • Inositol
  • N-acetylaspartate