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Quantitative spectroscopic imaging predicts outcome in MLD patients

11 Jan 2018
The fMRI brain scans from UBC Mind Wandering Study. Photo credit: Kalina Christoff/Science Daily

Use of proton magnetic resonance spectroscopic imaging at baseline predicts clinical course of patients with metachromatic leukodystrophy (MLD) and helps identify those eligible for haematopoietic cell transplantation (HCT), according to a retrospective study.

Sixteen of 21 patients with baseline scans (five with good, three with moderate and eight with poor outcome) met the inclusion criteria and were compared with 16 controls in the same age group.

There were significant differences for all metabolite concentrations in white matter for all groups (p<0.001). Patients with MLD, compared with controls, had reduced N-acetylaspartate and glutamate, as well as increased myo-inositol and lactate, which was most pronounced in those with poor outcome (p<0.05 for all posthoc).

Logistic regression demonstrated complete data separation. Creatinine could distinguish poor from moderate and good outcome. The sum of glutamate and glutamine could differentiate from moderate and poor outcome. In addition, N-acetylaspartate could characterize all outcome groups.

The authors evaluated one or more follow-up examinations for 13 patients (eight with baseline scans), which showed stabilization or even partial normalization of metabolites among those with moderate and good outcome, clearly visible in the ratio of choline/N-acetylaspartate.

Of the 21 patients with juvenile or adult MLD included in this study, 12 were HCT-treated. The authors determined clinical outcome as good, moderate or poor. They also quantified metabolites in white matter and examined the significance of metabolite concentrations at baseline for outcome prediction using logistic regression analysis. Evolution of metabolic changes were assessed for patients with follow-up examinations.

MLD is an inherited white matter disorder that can be treated with HCT, according to the authors.

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Most Read Articles
Pearl Toh, 5 days ago
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Elvira Manzano, 2 days ago
Cancer patients at risk for recurrent venous thromboembolism (VTE) are less likely to experience recurrence with rivaroxaban compared with dalteparin, the Select-D trial has shown, ushering in a new standard of care (SoC) for cancer-related VTE.
6 days ago

It appears that patients with rheumatoid arthritis (RA) are at an increased risk of obstructive sleep apnoea (OSA) secondary to both traditional and RA-related risk factors, a recent study has found.

Yesterday
Weight loss medications that have received the Food and Drug Administration (FDA) approval appear to confer only modest positive benefits for cardiometabolic risk profile, according to a study.