N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis.

Authors

Shiva Shahrampour, Thomas Jefferson UniversityFollow
Justin Heholt, Thomas Jefferson UniversityFollow
Andrew Wang, Florida Atlantic University
Faezeh Vedaei, Thomas Jefferson UniversityFollow
Feroze B. Mohamed, Thomas Jefferson UniversityFollow
Mahdi Alizadeh, Thomas Jefferson UniversityFollow
Ze Wang, University of Maryland
George Zabrecky, Thomas Jefferson UniversityFollow
Nancy Wintering, Thomas Jefferson UniversityFollow
Anthony J. Bazzan, Thomas Jefferson UniversityFollow
Thomas P. Leist, Thomas Jefferson UniversityFollow
Daniel A. Monti, Thomas Jefferson UniversityFollow
Andrew B. Newberg, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

7-16-2021

Comments

This article is the authors’ final published version in Heliyon, Volume 7, Issue 7, July 2021, Article number e07615.

The published version is available at https://doi.org/10.1016/j.heliyon.2021.e07615. Copyright © Shahrampour et al.

Abstract

Background: The purpose of this study was to explore if administration of N-acetyl-cysteine (NAC) in patients with multiple sclerosis (MS) resulted in altered cerebral blood flow (CBF) based on Arterial Spin Labeling (ASL) magnetic resonance imaging (MRI).

Methods: Twenty-three patients with mild to moderate MS, (17 relapsing remitting and 6 primary progressive) were randomized to either NAC plus standard of care (N = 11), or standard of care only (N = 12). The experimental group received NAC intravenously (50 mg/kg) once per week and orally (500mg 2x/day) the other six days. Patients in both groups were evaluated initially and after 2 months (of receiving the NAC or waitlist control) with ASL MRI to measure CBF. Clinical symptom questionnaires were also completed at both time points.

Results: The CBF data showed significant differences in several brain regions including the pons, midbrain, left temporal and frontal lobe, left thalamus, right middle frontal lobe and right temporal/hippocampus (p < 0.001) in the MS group after treatment with NAC, when compared to the control group. Self-reported scores related to cognition and attention were also significantly improved in the NAC group as compared to the control group.

Conclusions: The results of this study suggest that NAC administration alters resting CBF in MS patients, and this is associated with qualitative improvements in cognition and attention. Given these findings, large scale efficacy studies will be of value to determine the potential clinical impact of NAC over the course of illness in patients with MS, as well as the most effective dosages and differential effects across subpopulations.

Recommended Citation

Shahrampour, Shiva; Heholt, Justin; Wang, Andrew; Vedaei, Faezeh; Mohamed, Feroze B.; Alizadeh, Mahdi; Wang, Ze; Zabrecky, George; Wintering, Nancy; Bazzan, Anthony J.; Leist, Thomas P.; Monti, Daniel A.; and Newberg, Andrew B., "N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis." (2021). Department of Radiology Faculty Papers. Paper 110.
https://jdc.jefferson.edu/radiologyfp/110

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

34377857

Language

English