Quantitative Proton MR Spectroscopic Imaging in Acute Disseminated Encephalomyelitis

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2001 Jun 21

PMID 11415908

Citations 20

Authors

A Bizzi

A M Ulug

T O Crawford

T Passe

M Bugiani

R N Bryan

P B Barker

Affiliations

Soon will be listed here.

Abstract

Serial MR imaging and quantitative proton MR spectroscopic imaging (MRSI) findings of a 4-year-old boy with acute disseminated encephalomyelitis (ADEM) are reported. Over a 2-month period characterized by an initial illness and two relapses, each with full recovery, MR imaging exhibited the appearance and disappearance of multifocal lesions throughout the CNS that correlated only partly with the neurologic impairment. During one relapse, MRSI revealed low levels of N-acetylaspartate (NAA) within the regions of prolonged T2 signal intensity. All other metabolites were normal. At follow-up, the MR imaging and MRSI abnormalities had fully resolved. MRSI might play an important role in the diagnosis of ADEM, as well as in the elucidation of underlying pathophysiologic processes in this poorly defined disorder of children. This case demonstrates that reduced levels of NAA are not always associated with neuronal loss, irreversible tissue damage, or poor neurologic outcome.

Citing Articles

Pediatric Neuroimaging of Multiple Sclerosis and Neuroinflammatory Diseases.

Dunseath C, Bova E, Wilson E, Care M, Cecil K Tomography. 2024; 10(12):2100-2127.

PMID: 39728911 PMC: 11679236. DOI: 10.3390/tomography10120149.

Quantifying the Metabolic Signature of Multiple Sclerosis by Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker.

Swanberg K, Landheer K, Pitt D, Juchem C Front Neurol. 2019; 10:1173.

PMID: 31803127 PMC: 6876616. DOI: 10.3389/fneur.2019.01173.

MR spectroscopy in children: protocols and pitfalls in non-tumorous brain pathology.

Schneider J Pediatr Radiol. 2016; 46(7):963-82.

PMID: 27233789 DOI: 10.1007/s00247-014-3270-z.

Imaging neuroinflammation? A perspective from MR spectroscopy.

Zahr N, Mayer D, Rohlfing T, Sullivan E, Pfefferbaum A Brain Pathol. 2014; 24(6):654-64.

PMID: 25345895 PMC: 4493672. DOI: 10.1111/bpa.12197.

Pneumococcal-meningitis associated acute disseminated encephalomyelitis (ADEM) - case report of effective early immunotherapy.

Huhn K, Lee D, Linker R, Kloska S, Huttner H Springerplus. 2014; 3:415.

PMID: 25140291 PMC: 4137046. DOI: 10.1186/2193-1801-3-415.

References

Vion-Dury J, Nicoli F, Salvan A, Confort-Gouny S, Dhiver C, Cozzone P . Reversal of brain metabolic alterations with zidovudine detected by proton localised magnetic resonance spectroscopy. Lancet. 1995; 345(8941):60-1. DOI: 10.1016/s0140-6736(95)91184-7. View

Kesselring J, Miller D, Robb S, Kendall B, Moseley I, Kingsley D . Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. Brain. 1990; 113 ( Pt 2):291-302. DOI: 10.1093/brain/113.2.291. View

Soher B, van Zijl P, Duyn J, Barker P . Quantitative proton MR spectroscopic imaging of the human brain. Magn Reson Med. 1996; 35(3):356-63. DOI: 10.1002/mrm.1910350313. View

Duyn J, Gillen J, Sobering G, van Zijl P, Moonen C . Multisection proton MR spectroscopic imaging of the brain. Radiology. 1993; 188(1):277-82. DOI: 10.1148/radiology.188.1.8511313. View

Burlina A, Ferrari V, Facci L, Skaper S, Burlina A . Mast cells contain large quantities of secretagogue-sensitive N-acetylaspartate. J Neurochem. 1997; 69(3):1314-7. DOI: 10.1046/j.1471-4159.1997.69031314.x. View

Bates T, Strangward M, Keelan J, Davey G, Munro P, Clark J . Inhibition of N-acetylaspartate production: implications for 1H MRS studies in vivo. Neuroreport. 1996; 7(8):1397-400. View

Barker P, Bryan R, Kumar A, Naidu S . Proton NMR spectroscopy of Canavan's disease. Neuropediatrics. 1992; 23(5):263-7. DOI: 10.1055/s-2008-1071355. View

Bhakoo K, Pearce D . In vitro expression of N-acetyl aspartate by oligodendrocytes: implications for proton magnetic resonance spectroscopy signal in vivo. J Neurochem. 2000; 74(1):254-62. DOI: 10.1046/j.1471-4159.2000.0740254.x. View

Davie C, Hawkins C, Barker G, Brennan A, Tofts P, Miller D . Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. Brain. 1994; 117 ( Pt 1):49-58. DOI: 10.1093/brain/117.1.49. View

10.

Hugg J, Kuzniecky R, Gilliam F, Morawetz R, Fraught R, Hetherington H . Normalization of contralateral metabolic function following temporal lobectomy demonstrated by 1H magnetic resonance spectroscopic imaging. Ann Neurol. 1996; 40(2):236-9. DOI: 10.1002/ana.410400215. View

11.

Kruse B, Barker P, van Zijl P, Duyn J, Moonen C, Moser H . Multislice proton magnetic resonance spectroscopic imaging in X-linked adrenoleukodystrophy. Ann Neurol. 1994; 36(4):595-608. DOI: 10.1002/ana.410360408. View

12.

Nasr J, Andriola M, Coyle P . ADEM: literature review and case report of acute psychosis presentation. Pediatr Neurol. 2000; 22(1):8-18. DOI: 10.1016/s0887-8994(99)00116-2. View

13.

Barker P, Szopinski K, Horska A . Metabolic heterogeneity at the level of the anterior and posterior commissures. Magn Reson Med. 2000; 43(3):348-54. DOI: 10.1002/(sici)1522-2594(200003)43:3<348::aid-mrm5>3.0.co;2-m. View

14.

Birken D, Oldendorf W . N-acetyl-L-aspartic acid: a literature review of a compound prominent in 1H-NMR spectroscopic studies of brain. Neurosci Biobehav Rev. 1989; 13(1):23-31. DOI: 10.1016/s0149-7634(89)80048-x. View

15.

Barkovich A, Good W, Koch T, Berg B . Mitochondrial disorders: analysis of their clinical and imaging characteristics. AJNR Am J Neuroradiol. 1993; 14(5):1119-37. PMC: 8332760. View

16.

Guimaraes A, Schwartz P, Prakash M, Carr C, Berger U, Jenkins B . Quantitative in vivo 1H nuclear magnetic resonance spectroscopic imaging of neuronal loss in rat brain. Neuroscience. 1995; 69(4):1095-1101. DOI: 10.1016/0306-4522(95)00300-8. View

17.

Takanashi J, Sugita K, Ishii M, Aoyagi M, Niimi H . Longitudinal MR imaging and proton MR spectroscopy in herpes simplex encephalitis. J Neurol Sci. 1997; 149(1):99-102. DOI: 10.1016/s0022-510x(97)05401-4. View

18.

Harada M, Hisaoka S, Mori K, Yoneda K, Noda S, Nishitani H . Differences in water diffusion and lactate production in two different types of postinfectious encephalopathy. J Magn Reson Imaging. 2000; 11(5):559-63. DOI: 10.1002/(sici)1522-2586(200005)11:5<559::aid-jmri12>3.0.co;2-c. View

19.

De Stefano N, Matthews P, Arnold D . Reversible decreases in N-acetylaspartate after acute brain injury. Magn Reson Med. 1995; 34(5):721-7. DOI: 10.1002/mrm.1910340511. View