Plasma cerebrosterol and magnetic resonance imaging measures in multiple sclerosis

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. 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 T 1-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 T 2-weighted scans, volume of hyperintense lesions (a marker of disease extent). 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 T 2-weighted lesions ( β = −0.52 and p = 0.078 in RRMS; β = −0.50 and p = 0.247 in PPMS). 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.