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To assess this early axonal pathology, we quantified the concentration of whole-brain N-acetylaspartate (WBNAA) in a group of patients at the earliest clinical stage of the disease and compared the results with those from healthy controls. Conventional brain MRI and WBNAA using unlocalized protein magnetic resonance spectroscopy were obtained from 31 patients at presentation with clinically isolated syndromes suggestive of multiple sclerosis and paraclinical evidence of dissemination in space, and from 16 matched controls. Widespread axonal pathology, largely independent of MRI-visible inflammation and too extensive to be completely reversible, occurs in patients even at the earliest clinical stage of multiple sclerosis. This finding lessens the validity of the current concept that the axonal pathology of multiple sclerosis is the end-stage result of repeated inflammatory events, and argues strongly in favour of early neuroprotective intervention. |
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axonal degeneration MRI MRI,abnormal MRI,false negative MRS multiple sclerosis multiple sclerosis,monosymptomatic multiple sclerosis,pathogenesis multiple sclerosis,treatment of multiple sclerosis,treatment of,first attack N-acetyl-L-aspartic acid neuropathology neuroprotective agents treatment of neurologic disorder
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