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Table 1.

Patient and control characteristics at baseline.

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Fig 1.

Typical LCmodel spectra.

Example of a typical LCModel spectrum for each examination and VOI placement partial left. Data from a female patient 31 years old at baseline.

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Table 2.

1H-MRS metabolite concentrations at baseline and follow-up (paired patient data only).

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Table 2 Expand

Fig 2.

Correlation plots of tNA and mIns concentrations versus disease duration.

Correlation plots showing concentrations of 1H-MRS metabolite tNA (a) and mIns (b) versus disease duration at baseline. n = 18 because of lack of data in one patient (insidious disease start of progressive MS with radiologic disease activity). r and p refer to Spearman correlation coefficients. p < 0.05 is considered statistically significant. Line indicates simple linear regression fit with 95% confidence interval. tNA, total N-acetylaspartate and N-acetylaspartylglutamate; mIns, myo-inositol.

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Fig 3.

Consistent inverse correlations between concentrations of tNA and mIns.

Correlation plots showing concentrations of 1H-MRS metabolite tNA versus mIns at baseline (a) and follow-up after one (b) and three (c) years of treatment. r and p refer to Pearson correlation coefficients. p < 0.05 is considered statistically significant. Lines indicate simple linear regression fit with 95% confidence interval. tNA, total N-acetylaspartate and N-acetylaspartylglutamate; mIns, myo-inositol.

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Fig 3 Expand

Fig 4.

Glx concentrations correlate with concentrations of tNA and mIns at 3-years follow-up.

Correlation plots showing concentrations of 1H-MRS metabolite Glx versus tNA (a) and Glx versus mIns (b) after 3 years treatment with dimethyl fumarate. r and p refer to Pearson correlation coefficient. p < 0.05 is considered statistically significant. Lines indicate simple linear regression fit with 95% confidence interval. Glx, the sum of glutamate and glutamine; tNA, total N-acetylaspartate and N-acetylaspartylglutamate; mIns, myo-inositol.

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Fig 4 Expand

Fig 5.

Correlation between ratios of metabolite concentrations versus disease duration.

Correlation plots showing ratios of 1H-MRS metabolite concentrations of mIns and tNA versus disease duration (a) and tNA and tCr versus disease duration (b). n = 18 because of lack of data in one patient (insidious disease start of progressive MS with radiologic disease activity). r and p refer to Spearman correlation coefficients. p < 0.05 is considered statistically significant. Lines indicate simple linear regression fit with 95% confidence interval. tNA, total N-acetylaspartate and N-acetylaspartylglutamate; mIns, myo-inositol.

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Fig 5 Expand