M Agnetic Resonance Imaging in R Elapsing-rem Itting M Ultiple Sclerosis

The work presented in this thesis employed magnetic resonance imaging (MRI) techniques to determine the volume and metabolite profile of brain grey matter (GM) and white matter (WM) in people with clinically early relapsingremitting m ultiple sclerosis (MS). C ross-sectional MRI and clinical data was obtained from 27 subjects with relapsing-remitting MS within 3 years of first symptom onset, and com pared with MRI data from 29 normal control subjects. Subsets o f these groups also provided longitudinal data over 18 months for volumetric analysis. The principal observations were that: GM and WM atrophy may be observed early in the clinical course o f the disease; WM atrophy was more apparent at baseline, but over the period of follow-up GM atrophy occurred more rapidly than that o f WM; changes in metabolite concentrations were found in GM and WM suggesting neuronal and axonal dam age, and WM glial activation and or proliferation; WM lesion loads explained a fraction of GM and WM atrophy and metabolite variability; clinical outcome related more closely to tissue metabolite changes (GM glutamate and glutamine, and normal-appearing WM inositol) than atrophy at this stage of the disease.