It is possible to distinguish people with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) from those without either disease using ANOVA and multivariate analysis tests, according to a new study published in the journal Multiple Sclerosis and Related Disorders. The chosen metabolite profile analyses could even help distinguish the two conditions, according to the study authors.

NMOSD is often misdiagnosed as MS. It is, therefore, important to have diagnostic tools that can differentiate between the 2 conditions. 

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Here, a team of researchers led by Malgorzata Chalimoniuk, PhD in Department of Physical Education and Health in Biala Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Poland, assessed whether serum metabolic profile could be helpful in the differentiation of the 2 diseases in their early stages.

To this end, they collected blood samples from patients diagnosed with MS and NMOSD according to the 2010 McDonald criteria and 2015 criteria respectively. They then used proton magnetic resonance spectroscopy (1H-NMR) to obtain the metabolic profiles of hydrophilic and hydrophobic compounds in the serum of the patients. They also used isotope-specific detection mass spectrometry to measure serum metal levels.

The results showed there were significant differences in the levels of 10 metabolite signals in MS patients compared to controls. Between NMOSD patients and controls, there were significant differences in the levels of 18 metabolite signals. 

When they compared the samples obtained from patients with MS and those with NMOSD, the researchers found that there were significant differences in the levels of 5 metabolite signals. 

When they conducted a multivariate analysis of patient groups, researchers identified compounds that are involved in inflammation and/or oxidative stress and when they conducted metallomics studies, the researchers saw that metals participated in these processes.

“Our studies on serum metabolite profiles and metal levels pointed to two main mechanisms involved in the development of both diseases,” the researchers wrote. “These mechanisms are inflammation and oxidative stress leading to damage to the myelin sheaths and the death of nerve cells”.


Toczylowska B, Zieminska E, Podlecka-Pietowska A, Ruszczynska A, Chalimoniuk M, et al. Serum metabolic profiles and metal levels of patients with multiple sclerosis and patients with neuromyelitis optica spectrum disorders – NMR spectroscopy and ICP–MS studies. Mult Scler Relat Disord. Published online February 6, 2022. doi:10.1016/j.msard.2022.103672