Markedly lower brain antioxidant glutathione (GSH) in progressive multiple sclerosis (MS) than relapsing-remitting MS (RRMS) indicates more prominent involvement of oxidative stress in the progressive stage of MS than the inflammatory stage, a recent study found. The association between GSH and brain atrophy suggests the important role of oxidative stress contributing to neurodegeneration in progressive MS, as suggested in other neurodegenerative diseases. GSH mapping was performed on the fronto-parietal region of patients with RRMS (n=21), primary progressive multiple sclerosis (PPMS, n=20), secondary progressive multiple sclerosis (SPMS, n=20), and controls (n=28) using GSH chemical shift imaging. Between-group comparisons were performed on all variables (GSH, T2-lesion, atrophy, Expanded Disability Status Scale [EDSS]). Researchers found:

• Patients with MS had substantially lower GSH concentrations than controls, and GSH was lower in PPMS and SPMS compared with RRMS.
• GSH concentrations were not significantly different between PPMS and SPMS, or between RRMS and controls.
• Brain atrophy was significant in both RRMS and progressive MS compared with controls.