caa a22 4500 445808705 CHVBK 20180317145204.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00415-011-6117-7 doi (NATIONALLICENCE)springer-10.1007/s00415-011-6117-7 Energy failure in multiple sclerosis and its investigation using MR techniques [Elektronische Daten] [David Paling, Xavier Golay, Claudia Wheeler-Kingshott, Raju Kapoor, David Miller] Energy failure is an emerging concept in multiple sclerosis research. Pathological studies have indicated that axonal modifications in response to demyelination may increase neuronal energy demand. At the same time, soluble mediators of inflammation may impair mitochondrial function, and brain perfusion may also be decreased. Insufficient energy production for demand can lead to intracellular sodium accumulation, calcium influx and cell death. Magnetic resonance (MR) is a promising technique to investigate these pathology driven hypotheses in vivo. MR spectroscopy can inform on mitochondrial function with measures of N acetyl aspartate (NAA), and requirement for extra-mitochondrial glycolysis via measurement of lactate. MR measurement of phosphorous (31P) and sodium (23Na) allows direct assessment of energy availability and axonal sodium handling. MR techniques for imaging perfusion can quantify oxygen delivery and nascent MR techniques that exploit the paramagnetism of deoxyhaemaglobin may be able to quantify oxygen utilization. This report reviews the physical principles underlying these techniques, their implementation for human in vivo imaging, and their application in neurological conditions with an emphasis on multiple sclerosis. Combination of these techniques to obtain a comprehensive picture of oxygen delivery, energy production and utilization may provide new insights into the pathophysiology of multiple sclerosis and may provide outcome measures for trials of novel treatments. Springer-Verlag, 2011 Multiple sclerosis nationallicence Magnetic resonance imaging nationallicence Magnetic resonance spectroscopy nationallicence Perfusion imaging nationallicence Oxygen consumption nationallicence N acetyl acetate nationallicence Lactate nationallicence Paling David NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut Golay Xavier Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut Wheeler-Kingshott Claudia NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut Kapoor Raju NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut Miller David NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut Journal of Neurology Springer-Verlag 258/12(2011-12-01), 2113-2127 0340-5354 258:12<2113 2011 258 415 https://doi.org/10.1007/s00415-011-6117-7 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-6117-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Paling David NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Golay Xavier Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Wheeler-Kingshott Claudia NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Kapoor Raju NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Miller David NMR Research Unit, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/12(2011-12-01), 2113-2127 0340-5354 258:12<2113 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer