Faculty Bibliography

We used quantitative magnetic resonance (MR) spectroscopic imaging with T1-based image segmentation to evaluate the subtypes of multiple sclerosis (MS) (eight patients each group of relapsing-remitting [RR], secondary progressive [SP] and primary progressive [PP]). There was no significant difference in age between the PP group with the RP, SP or control group. We found that the metabolite ratio of choline/NA from the periventricular white matter region was not significantly different between the RR and SP groups. Using an ANOVA, the ratios of periventricular choline/NA or creatine/NA of these combined groups were significantly higher than the PP and control groups. Quantification of these data suggest that the major cause of the elevation of these parameters is due to an increase in choline and creatine in the RR group while NA is decreased in the SP group. Thus, early PP disease appears to be relatively intact with respect to neuronal loss.

The symptoms that affect individuals with MS are diverse and change over time. Addressing symptoms in a multidisciplinary fashion and helping patients address problems as they occur are the major elements of symptom management. Successful management involves treating not only the more readily recognized manifestations of MS but also the less apparent MS features, including fatigue, cognitive loss, mood disturbance, and pain. Management of these symptoms is reviewed.