Reduced GABA levels correlate with cognitive impairment in patients with relapsing-remitting multiple sclerosis

• Published in: European radiology Vol. 28; no. 3; pp. 1140 - 1148
• Main Authors: Cao, Guanmei, Edden, Richard A. E., Gao, Fei, Li, Hao, Gong, Tao, Chen, Weibo, Liu, Xiaohui, Wang, Guangbin, Zhao, Bin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2018; Springer Nature B.V
• Subjects: Abnormalities; Adult; Brain; Brain - metabolism; Case-Control Studies; Cognitive ability; Cognitive Dysfunction - etiology; Cognitive Dysfunction - metabolism; Cortex (cingulate); Diagnostic Radiology; Female; gamma-Aminobutyric Acid - metabolism; Gyrus Cinguli - metabolism; Hippocampus; Humans; Imaging; Impairment; Interferon; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic Resonance Imaging; Magnetic resonance spectroscopy; Magnetic Resonance Spectroscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Multiple Sclerosis, Relapsing-Remitting - metabolism; Multiple Sclerosis, Relapsing-Remitting - psychology; Neuropsychological Tests; Neuroradiology; Neurotransmission; Pathogenesis; Patients; Prefrontal cortex; Prefrontal Cortex - metabolism; Radiology; Severity of Illness Index; Spectroscopy; Spectrum analysis; Temporal Lobe - metabolism; Ultrasound; γ-Aminobutyric acid; GABA; MEGA-PRESS; Multiple sclerosis; H-MRS; Cognitive impairment; 1H-MRS
• DOI: 10.1007/s00330-017-5064-9
• ISSN: 0938-7994; 1432-1084

Objectives To investigate if brain gamma-aminobutyric acid (GABA) levels in patients with relapsing-remitting multiple sclerosis (RRMS) are abnormal compared with healthy controls, and their relationship to cognitive function in RRMS. Methods Twenty-eight RRMS patients and twenty-six healthy controls underwent magnetic resonance spectroscopy (MRS) at 3-T to detect GABA signals from posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) and left hippocampus using the ‘MEGAPoint Resolved Spectroscopy Sequence’ (MEGA-PRESS) technique. All subjects also underwent a cognitive assessment. Results In RRMS patients, GABA+ were lower in the PCC ( p = 0.036) and left hippocampus ( p = 0.039) compared with controls, decreased GABA+ in the PCC and left hippocampus were associated with specific cognitive functions (r = -0.452, p = 0.016 and r = 0.451, p = 0.016 respectively); GABA+ in the mPFC were not significantly decreased or related to any cognitive scores ( p > 0.05). Conclusions This study demonstrates that abnormalities of the GABAergic system may be present in the pathogenesis of RRMS and suggests a potential link between regional GABA levels and cognitive impairment in patients with RRMS. Key points • GABA levels may decrease in patients with RRMS . • Lower GABA levels correlated with worse cognitive performance in patients with RRMS . • Dysfunctional GABAergic neurotransmission may have a role in cognitive impairment in RRMS .