Title
|
|
|
|
Targeting phosphocreatine metabolism in relapsing-remitting multiple sclerosis: evaluation with brain MRI, and MRS, and clinical and cognitive testing
| |
Author
|
|
|
|
| |
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 (H-1) and phosphorus (P-31) 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 P-31 and H-1 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 P-31 and H-1 MRS parameters, suggesting that these molecules do not influence the PCr metabolism. |
| |
Language
|
|
|
|
English
| |
Source (journal)
|
|
|
|
Journal of neurology. - Berlin, 1974, currens
| |
Publication
|
|
|
|
Berlin
:
2018
| |
ISSN
|
|
|
|
0340-5354
[print]
1432-1459
[online]
| |
DOI
|
|
|
|
10.1007/S00415-018-9039-9
| |
Volume/pages
|
|
|
|
265
:11
(2018)
, p. 2614-2624
| |
ISI
|
|
|
|
000448450200013
| |
Pubmed ID
|
|
|
|
30187159
| |
Full text (Publisher's DOI)
|
|
|
|
| |
Full text (publisher's version - intranet only)
|
|
|
|
| |
|