RT Journal Article
SR Electronic
T1 Serum and CSF N-acetyl aspartate levels differ in multiple sclerosis and neuromyelitis optica
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1355
OP 1359
DO 10.1136/jnnp.2011.241836
VO 82
IS 12
A1 C Tortorella
A1 M Ruggieri
A1 E Di Monte
A1 E Ceci
A1 P Iaffaldano
A1 V Direnzo
A1 M Mastrapasqua
A1 A Frigeri
A1 M P Amato
A1 B Hakiki
A1 A Ghezzi
A1 A Lugaresi
A1 G De Luca
A1 F Patti
A1 E D'amico
A1 P Sola
A1 A M Simone
A1 M Svelto
A1 P Livrea
A1 M Trojano
YR 2011
UL http://jnnp.bmj.com/content/82/12/1355.abstract
AB Background The identification of biomarkers able to improve the differential diagnosis between multiple sclerosis (MS) and neuromyelitis optica (NMO) is challenging because of a different prognosis and response to treatment. Growing evidence indicates that brain and CSF N-acetyl aspartate (NAA) concentration is a useful marker for characterising different phases of axonal pathology in demyelinating diseases, and preliminary studies suggest that increased serum NAA levels may be a telltale sign of acute neuronal damage or defective NAA metabolism in oligodendrocytes.Objective To evaluate whether serum and CSF NAA concentration differs in patients with MS and NMO.Design Observational, multicentre, prospective, cross sectional study.Methods Serum samples were collected from 48 relapsing–remitting MS, 32 NMO and 76 age matched healthy controls. Coeval CSF samples were available for all MS and for 8/32 NMO patients. NAA was measured in serum and CSF by liquid chromatography–mass spectrometry.Results MS patients showed higher serum and CSF NAA levels than NMO patients, and higher serum NAA levels than healthy controls (p<0.001). High serum NAA values, exceeding the 95th percentile of serum NAA values in healthy controls, were found in 100% of patients with MS and in no patient with NMO. No differences in serum NAA levels were found between NMO and healthy controls. In MS, serum and CSF NAA levels correlated with disability score.Conclusions Determination of serum and CSF NAA levels may represent a suitable tool in the diagnostic laboratory workup to differentiate MS and NMO.