• Guanmei Cao, EddenRichard A ERAERussell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.FM Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21287, Fei Gao, Hao Li, Tao Gong, Weibo Chen, Xiaohui Liu, Guangbin Wang, and Bin Zhao.
• Shandong Medical Imaging Research Institute, Shandong University, Jinan, 250021, Shandong, China.
• Eur Radiol. 2018 Mar 1; 28 (3): 1140-1148.

ObjectivesTo investigate if brain gamma-aminobutyric acid (GABA) levels in patients with relapsing-remitting multiple sclerosis (RRMS) are abnormal compared with healthy controls, and their relationship to cognitive function in RRMS.MethodsTwenty-eight RRMS patients and twenty-six healthy controls underwent magnetic resonance spectroscopy (MRS) at 3-T to detect GABA signals from posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) and left hippocampus using the 'MEGAPoint Resolved Spectroscopy Sequence' (MEGA-PRESS) technique. All subjects also underwent a cognitive assessment.ResultsIn RRMS patients, GABA+ were lower in the PCC (p = 0.036) and left hippocampus (p = 0.039) compared with controls, decreased GABA+ in the PCC and left hippocampus were associated with specific cognitive functions (r = -0.452, p = 0.016 and r = 0.451, p = 0.016 respectively); GABA+ in the mPFC were not significantly decreased or related to any cognitive scores (p > 0.05).ConclusionsThis study demonstrates that abnormalities of the GABAergic system may be present in the pathogenesis of RRMS and suggests a potential link between regional GABA levels and cognitive impairment in patients with RRMS.Key Points• GABA levels may decrease in patients with RRMS. • Lower GABA levels correlated with worse cognitive performance in patients with RRMS. • Dysfunctional GABAergic neurotransmission may have a role in cognitive impairment in RRMS.

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