{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:16:48Z","timestamp":1772003808815,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":3752,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1994,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Decreases in brain <jats:italic>N<\/jats:italic>\u2010acetylasparatate are associated with neuronal loss or dysfunction. We report a longitudinal study in which changes in the <jats:italic>N<\/jats:italic>\u2010acetylaspartate to creatine resonance intensity ratio measured by brain proton magnetic resonance spectroscopy were used to follow the progression of brain pathology in 7 patients with multiple sclerosis over an 18\u2010month period. Four of the patients had a history of recurrent relapses and 3 had a secondary progressive course. All had clinical and magnetic resonance imaging evidence of persistent neurological abnormalaties. At 6\u2010month intervals proton magnetic resonance spectra were obtained and the <jats:italic>N<\/jats:italic>\u2010acetylaspartate\u2013creatine ratio was determined for each patient. The volumes of hyperintense signal from lesions on conventional magnetic resonance images and the Kurtzke Expanded Disability Status Scale scores were determined concurrently. At the onset of the study, the <jats:italic>N<\/jats:italic>\u2010acetylaspartate\u2013creatine ratio was significantly (<jats:italic>p<\/jats:italic> &lt; 0.05) lower in the central brain volumes from the patients than in 13 normal control subjects. At 12 and 18 months of follow\u2010up, the ratio had decreased further in all patients (<jats:italic>p<\/jats:italic> &lt; 0.05), consistent with progressive accumulation of neuronal damage. In contrast to magnetic resonance spectra data, changes in lesion volume on magnetic resonance images or disability status did not reach significance over this period. Subgroup analysis showed that changes (increases or decreases) in the <jats:italic>N<\/jats:italic>\u2010acetylaspartate\u2013creatine ratio between consecutive 6\u2010month examinations correlated significantly (<jats:italic>r<\/jats:italic> = \u20130.74, <jats:italic>p<\/jats:italic> &lt; 0.005) with changes in lesion volume on magnetic resonance images in patients with a history of relapses. This pilot study suggests that proton magnetic resonance spectroscopy may be useful in evaluating the progression of cerebral damage in multiple sclerosis using a novel quantitative index based on neuronal damage or dysfunction.<\/jats:p>","DOI":"10.1002\/ana.410360115","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T16:04:30Z","timestamp":1104595470000},"page":"76-82","source":"Crossref","is-referenced-by-count":141,"title":["Use of proton magnetic resonance spectroscopy for monitoring disease progression in multiple sclerosis"],"prefix":"10.1002","volume":"36","author":[{"given":"Douglas L.","family":"Arnold","sequence":"first","affiliation":[]},{"given":"Gerald T.","family":"Riess","sequence":"additional","affiliation":[]},{"given":"Paul M.","family":"Matthews","sequence":"additional","affiliation":[]},{"given":"Gordon S.","family":"Francis","sequence":"additional","affiliation":[]},{"given":"D. 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