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05.09.2018 | Original Communication

Targeting phosphocreatine metabolism in relapsing–remitting multiple sclerosis: evaluation with brain MRI, ¹H and ³¹P MRS, and clinical and cognitive testing

verfasst von: Melissa Cambron, Tatjana Reynders, Jan Debruyne, Harmen Reyngoudt, Annemie Ribbens, Erik Achten, Guy Laureys

Erschienen in: Journal of Neurology | Ausgabe 11/2018

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Abstract

Background/objectives

Fluoxetine and prucalopride might change phosphocreatine (PCr) levels via the cAMP–PKA pathway, an interesting target in the neurodegenerative mechanisms of MS.

Methods

We conducted a two-center double-blind, placebo-controlled, randomized trial including 48 relapsing–remitting MS patients. Patients were randomized to receive placebo (n = 13), fluoxetine (n = 15), or prucalopride (n = 14) for 6 weeks. Proton (¹H) and phosphorus (³¹P) magnetic resonance spectroscopy (MRS) as well as volumetric and perfusion MR imaging were performed at weeks 0, 2, and 6. Clinical and cognitive testing were evaluated at weeks 0 and 6.

Results

No significant changes were observed for both ³¹P and ¹H MRS indices. We found a significant effect on white matter volume and a trend towards an increase in grey matter and whole brain volume in the fluoxetine group at week 2; however, these effects were not sustained at week 6 for white matter and whole brain volume. Fluoxetine and prucalopride showed a positive effect on 9-HPT, depression, and fatigue scores.

Conclusion

Both fluoxetine and prucalopride had a symptomatic effect on upper limb function, fatigue, and depression, but this should be interpreted with caution. No effect of treatment was found on ³¹P and ¹H MRS parameters, suggesting that these molecules do not influence the PCr metabolism.

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Titel: Targeting phosphocreatine metabolism in relapsing–remitting multiple sclerosis: evaluation with brain MRI, 1H and 31P MRS, and clinical and cognitive testing
verfasst von: Melissa Cambron
Tatjana Reynders
Jan Debruyne
Harmen Reyngoudt
Annemie Ribbens
Erik Achten
Guy Laureys
Publikationsdatum: 05.09.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 11/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-9039-9

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Targeting phosphocreatine metabolism in relapsing–remitting multiple sclerosis: evaluation with brain MRI, ¹H and ³¹P MRS, and clinical and cognitive testing

Abstract

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Methods

Results

Conclusion

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Conclusion

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