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SINAPSE Image of the Month: MR spectroscopy of brain white matter

August 2018 SINAPSE Image of the Month

Courtesy of Prof Ian Marshall, this image shows a magnetic resonance spectroscopic imaging (MRSI) slice for measuring brain metabolites in an individual with secondary progressive multiple sclerosis. The spectroscopic excitation volume is shown with a red outline, and tissue segmentation is illustrated with coloured shading: green indicates normal-appearing white matter and pale blue indicates white matter lesions (WML) which are characteristic of multiple sclerosis.

MRSI estimates metabolite concentrations in voxels within the brain, and can be used to investigate differences in metabolite levels between tissue types within individuals. In a group of patients with secondary progressive multiple sclerosis, MRSI showed higher levels of choline, creatine and myo-inositol in WML relative to normal-appearing white matter. These differences are indicative of higher myelin turnover, higher metabolic rate and increased glial activity in WML, suggesting that the lesions have ongoing abnormal metabolism, which may represent a target for repair therapies.

 

The image is taken from a recent study published in Journal of Neurology:

Marshall I, Thrippleton MJ, Bastin ME, Mollison D, Dickie DA, Chappell FM, Semple SIK, Cooper A, Pavitt S, Giovannoni G, Wheeler-Kingshott CAMG, Solanky BS, Weir CJ, Stallard N, Hawkins C, Sharrack B, Chataway J, Connick P, Chandran S; for the MS-SMART Trialists. Characterisation of tissue-type metabolic content in secondary progressive multiple sclerosis: a magnetic resonance spectroscopic imaging study. J Neurol 2018; 265:1795-1802.