Plasma cerebrosterol and magnetic resonance imaging measures in multiple sclerosis

Objectives: The concentration in plasma of the brain-specific cholesterol metabolite cerebrosterol has been proposed as a biomarker of neurodegeneration in multiple sclerosis (MS) and other neurological diseases. It is unknown, however, which pathophysiological process in MS best accounts for variations in plasma cerebrosterol. Patients and methods: In this study, we related plasma cerebrosterol concentrations in 46 MS patients - 27 with a relapsing-remitting (RR) disease course and 19 with a primary progressive (PP) course - to three conventional magnetic resonance imaging measures: on T1-weighted brain scans, volume of gadolinium-enhanced lesions (a marker of active inflammation) and hypointense lesions (a marker of edema or axonal loss) and on T2-weighted scans, volume of hyperintense lesions (a marker of disease extent). Results: By multiple-regression analysis, we uncovered negative correlations between the cerebrosterol-cholesterol ratio in plasma and both age at sampling (β = -0.35 and p = 0.079 in RRMS; β = -0.76 and p = 0.006 in PPMS) and volume of T2-weighted lesions (β = -0.52 and p = 0.078 in RRMS; β = -0.50 and p = 0.247 in PPMS). Conclusion: We hypothesize that decreases in plasma cerebrosterol may reflect the total spatiotemporal burden of MS-the cumulative effects of its dissemination in space and its duration in time.