NUCLEAR-MAGNETIC-RESONANCE STUDY OF CEREBROSPINAL-FLUID FROM PATIENTSWITH MULTIPLE-SCLEROSIS

Proton nuclear magnetic resonance (NMR) spectroscopy was used to exami ne cerebrospinal fluid (CSF) from patients (n = 30) with actively prog ressive multiple sclerosis (MS). Metabolite concentrations obtained fr om the spectra were compared to those determined from the spectra of C SF from control patients (n = 27) with benign spinal disorders. No sig nificant difference was found between the 2 groups for most constituen ts, including lactate, glutamine, citrate, creatine and creatinine. an d glucose. Acetate levels were significantly higher in MS patients, wh ile formate levels were significantly lower, than the controls. There were no significant differences in metabolite concentrations in CSF fr om early and longstanding MS patients. A peak due to an unidentified c ompound was found at 2.82 ppm in the spectra of CSF from patients with actively progressive MS, but not in the spectra of CSF from the contr ols. The peak was not found in spectra of CSF from patients with AIDS dementia complex (n = 9) or Parkinson's disease (n = 5), but it did ap pear in spectra of CSF from 1 patient with Jakob-Creutzfeldt disease ( out of 3 examined) and from 1 patient (out of 7) with Guillan-Barre di sease. The unidentified compound is volatile and. from the chemical sh ift of the observed NMR peak. is probably an N-methyl compound. As suc h. it may be an intermediate in the cholino-glycine cycle, in which an abnormality has been proposed to exist in MS patients.