N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis
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...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844021017187 |
| _version_ | 1818600708961730560 |
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| author | Shiva Shahrampour Justin Heholt Andrew Wang Faezeh Vedaei Feroze B. Mohamed Mahdi Alizadeh Ze Wang George Zabrecky Nancy Wintering Anthony J. Bazzan Thomas P. Leist Daniel A. Monti Andrew B. Newberg |
| author_facet | Shiva Shahrampour Justin Heholt Andrew Wang Faezeh Vedaei Feroze B. Mohamed Mahdi Alizadeh Ze Wang George Zabrecky Nancy Wintering Anthony J. Bazzan Thomas P. Leist Daniel A. Monti Andrew B. Newberg |
| author_sort | Shiva Shahrampour |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T12:39:47Z |
| format | Article |
| id | doaj.art-1340621e17d44bbfbb07c695e03c319e |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-12-16T12:39:47Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-1340621e17d44bbfbb07c695e03c319e2022-12-21T22:31:27ZengElsevierHeliyon2405-84402021-07-0177e07615N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosisShiva Shahrampour0Justin Heholt1Andrew Wang2Faezeh Vedaei3Feroze B. Mohamed4Mahdi Alizadeh5Ze Wang6George Zabrecky7Nancy Wintering8Anthony J. Bazzan9Thomas P. Leist10Daniel A. Monti11Andrew B. Newberg12Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USADepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USACharles E. Schmidt College of Medicine, Marcus Institute of Integrative Health at FAU Medicine, Florida Atlantic University, Boca Raton, FL USADepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USADepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USADepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USADepartment of Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USADepartment of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USADepartment of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USADepartment of Neurology, Thomas Jefferson University, Philadelphia, PA, USADepartment of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USADepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, USA; Department of Integrative Medicine and Nutritional Sciences, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USA; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2405844021017187N-acetyl cysteineNACAntioxidantMultiple sclerosisArterial spin labeling MRICerebral blood flow |
| spellingShingle | Shiva Shahrampour Justin Heholt Andrew Wang Faezeh Vedaei Feroze B. Mohamed Mahdi Alizadeh Ze Wang George Zabrecky Nancy Wintering Anthony J. Bazzan Thomas P. Leist Daniel A. Monti Andrew B. Newberg N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis Heliyon N-acetyl cysteine NAC Antioxidant Multiple sclerosis Arterial spin labeling MRI Cerebral blood flow |
| title | N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis |
| title_full | N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis |
| title_fullStr | N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis |
| title_full_unstemmed | N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis |
| title_short | N-acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling MRI in patients with multiple sclerosis |
| title_sort | n acetyl cysteine administration affects cerebral blood flow as measured by arterial spin labeling mri in patients with multiple sclerosis |
| topic | N-acetyl cysteine NAC Antioxidant Multiple sclerosis Arterial spin labeling MRI Cerebral blood flow |
| url | http://www.sciencedirect.com/science/article/pii/S2405844021017187 |
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