This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Early biochemical changes have been observed in Relapsing Remitting Multiple Sclerosis (MSRR) using Magnetic Resonance Spectroscopy (MRS). Specifically, lower levels of N-Acetilaspartate (NAA), a metabolite associated with neural integrity, have been documented in MSRR patients compared to controls, however the prognostic capacity of these changes for cognitive decline in MS patients has not been established. Recent studies suggest that the biochemical changes associated with the disease are independent of visible lesions and can be observed in normal appearing grey and white matter at initial stages of MS, nonetheless, there is a need to study how these early changes influence cognitive and affective functions. Given the heterogeneity of Multiple Sclerosis the long-term goal is to study the earliest cognitive symptoms and biomarkers of Multiple Sclerosis to predict and ameliorate the progression of the disease. The current objective of this project is to study the biochemical and microstructural changes at the earliest stage of Relapsing Remitting Multiple Sclerosis and observe its current and prospective relation with cognitive functions in the Puerto Rican Population. The central hypothesis of this study is that early markers of neural integrity measured through novel techniques of Magnetic Resonance (like NAA/Cr ratios and DWI) will significantly differ in MSRR patients and healthy controls and can predict the cognitive and motor functioning of patients after 2 years.
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