KubilayAydin, Istanbul University, Istanbul Medical School, Department of Neuroradiology, Adnan Saygun Cad. M. Salihrustu bey sok. Ulus Konaklari, No: 8/12, Ulus, Istanbul , Turkeydr.aydink@superonline.com
Submitted November 07, 2006
We appreciate Dr. Anlar’s comments about our recent article regarding MR
spectroscopy findings in patient with subacute sclerosing panencephalitis
(SSPE). We investigated the correlations between neurometabolite
concentrations and duration of disease and clinical status of patients
with SSPE. [1] In our study, the mean mI concentration of in the patients
with stage 4 disease was lower than that of stage 3 patients.
Dr. Anlar
speculates that the regression of mI increase in stage 4 patient might
have been caused by the effect of inosiplex. [2]. However, there was no change
in the treatment protocols or in inosiplex dosage which would support
such a hypothesis. Also, an increase in N-acetyl aspartate (NAA)
concentration accompanying the decrease in mI concentration would be
expected if the decrease in mI concentration in stage 4 patients was due
to theropeutic effect of inosiplex alone.
In our study, the NAA
concentrations continued to decrease in stage 3 patients who
progressed into stage 4. A case of SSPE
in which a regression of mI increase was observed when the patient
progressed into stage 4 disease has been reported. [3] There is no data to support Dr.
Anlar’s speculation. We hypothesize that tissue necrosis developing in
cerebral tissue of stage 4 patients may decrease mI concentration by a
diluting effect.
Our study was not a longitidunal
study focused on investigating the effect of inosiplex on proton
MR spectroscopy findings of SSPE patients. There is no current, adequate treatment for SSPE and inosiplex is one of the few drugs
which has been shown to be partially effective in the treatment of SSPE.
Due to ethical issues, we could not investigate potential
effects of inosiplex on neurometabolite concentrations. However, the
significant correlations of neurometabolite concentrations with clinical
status of patients which have been observed in our study makes MR
spectroscopy a potential clinical tool to follow up SSPE patients.
Reference
3. Michael N, Erfurth A, Ludemann P, Schuierer G, Moller HE. Serial
proton spectroscopy in a case of adult onset subacute sclerosing
panencephalitis. Psychiatry Res 2005; 139: 269-273.
Disclosure: The authors report no conflicts of interest.
We appreciate Dr. Anlar’s comments about our recent article regarding MR spectroscopy findings in patient with subacute sclerosing panencephalitis (SSPE). We investigated the correlations between neurometabolite concentrations and duration of disease and clinical status of patients with SSPE. [1] In our study, the mean mI concentration of in the patients with stage 4 disease was lower than that of stage 3 patients.
Dr. Anlar speculates that the regression of mI increase in stage 4 patient might have been caused by the effect of inosiplex. [2]. However, there was no change in the treatment protocols or in inosiplex dosage which would support such a hypothesis. Also, an increase in N-acetyl aspartate (NAA) concentration accompanying the decrease in mI concentration would be expected if the decrease in mI concentration in stage 4 patients was due to theropeutic effect of inosiplex alone.
In our study, the NAA concentrations continued to decrease in stage 3 patients who progressed into stage 4. A case of SSPE in which a regression of mI increase was observed when the patient progressed into stage 4 disease has been reported. [3] There is no data to support Dr. Anlar’s speculation. We hypothesize that tissue necrosis developing in cerebral tissue of stage 4 patients may decrease mI concentration by a diluting effect.
Our study was not a longitidunal study focused on investigating the effect of inosiplex on proton MR spectroscopy findings of SSPE patients. There is no current, adequate treatment for SSPE and inosiplex is one of the few drugs which has been shown to be partially effective in the treatment of SSPE. Due to ethical issues, we could not investigate potential effects of inosiplex on neurometabolite concentrations. However, the significant correlations of neurometabolite concentrations with clinical status of patients which have been observed in our study makes MR spectroscopy a potential clinical tool to follow up SSPE patients.
Reference
3. Michael N, Erfurth A, Ludemann P, Schuierer G, Moller HE. Serial proton spectroscopy in a case of adult onset subacute sclerosing panencephalitis. Psychiatry Res 2005; 139: 269-273.
Disclosure: The authors report no conflicts of interest.