Objective Despite treatments which reduce relapses in multiple sclerosis (MS), many patients continue to experience progressive disability accumulation. MS is associated with metabolic disruptions and cerebral metabolic stress predisposes to tissue injury and possibly impaired remyelination. Additionally, myelin homeostasis is metabolically expensive and reliant on glycolysis. We investigated cerebral metabolic changes in MS and when in the disease course they occurred, and assessed their relationship with microstructural changes. Methods This study used combined fluorodeoxyglucose (FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) to measure cerebral metabolic rate of glucose and oxygen, thereby quantifying glycolysis. Twelve healthy controls, 20 patients with relapsing MS, and 13 patients with non‐relapsing MS were studied. Relapsing patients with MS were treatment naïve and scanned pre‐ and post‐initiation of high efficacy disease modifying therapy. Results In normal appearing white matter, we observed increased glucose utilization and reduced oxygen utilization in newly diagnosed MS, consistent with increased glycolysis. Increased glycolysis was greater in patients with a longer disease duration course and higher disability. Among newly diagnosed patients, different treatments had differential impacts on glucose utilization. Last, whereas hypermetabolism within lesions was clearly associated with inflammation, no such relationship was found within normal appearing white matter. Interpretation Increased white matter glycolysis is a prominent feature of cerebral metabolism in MS. It begins early in the disease course, increases with disease duration and is independent of microstructural evidence of inflammation in normal appearing white matter. Optimization of the metabolic environment may be an important component of therapies designed to reduce progressive disability. ANN NEUROL 2024

Matthew R Brier

Bradley Judge

Chunwei Ying

Amber Salter

Hongyu An

Aakash Patel

Qing Wang

Yong Wang

Anne H Cross

Robert T Naismith

Tammie LS Benzinger

Manu S Goyal

Annals of Neurology

《神经病学年鉴》发表了对神经病学具有广泛兴趣的文章，尤其是那些对理解人类神经系统疾病的机制和治疗有重大影响的文章。尽管 ANNALS 使用多种临床和基本神经科学方法发表论文，但我们最感兴趣的是学术神经学家普遍感兴趣的那些手稿，包括临床试验和其他为医学实践提供信息的大规模研究。纯粹的基础研究，没有很强的临床或转化潜力，不太可能有足够的优先发表权。

The Annals of Neurology publishes articles on a wide range of topics relevant to neurology, particularly those that have a significant impact on understanding the mechanisms and treatments of human neurological diseases. While the Annals employs various clinical and basic neuroscience methods for publication, we are particularly interested in manuscripts that are of general interest to academic neurologists, including clinical trials and large-scale studies that provide valuable information for medical practice. Purely basic research, lacking strong clinical or translational potential, is less likely to receive priority for publication.

《Annals of Neurology》发表了与神经病学相关的广泛主题文章，特别是那些对理解人类神经系统疾病的机制和治疗具有重要影响的研究。虽然《Annals of Neurology》采用多种临床和基础神经科学方法来发表论文，但我们特别关注那些学术神经学家普遍感兴趣的稿件，包括临床试验和其他为医学实践提供重要信息的大规模研究。纯粹的基础研究，若缺乏明显的临床或转化潜力，通常不具备优先发表的条件。

Category	Quartile
医学	1
医学, 临床神经病学	1
医学, 神经科学	1

Increased White Matter Aerobic Glycolysis in Multiple Sclerosis

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