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Multiple sclerosis (MS) is a common cause of chronic neurological disability in young adults. Magnetic Resonance Imaging (MRI) readily identifies multifocal white matter lesions(WML) that represent areas of demyelination and is thus useful in supporting the diagnosis of MS, even after a single clinical episode(McDonald et al., 2001). MRI is also widely used to monitor disease progression in natural history and in therapeutic trial studies. However, conventional MRI does not detect the subtle histopathological changes that are described in the normal-appearing white matter (NAWM) in patients with MS(Allen & McKeown, 1979; Bitsch et al., 1999). MRS has been used in the evaluation of MS to help further define the nature of the lesions revealed by T2-weighted MRI(Arnold, Matthews, Francis, O'Connor, & Antel, 1992; Arnold et al., 1994; Bitsch et al., 1999; Davie et al., 1997; De Stefano et al., 1995; Fu et al., 1998; Gonen et al., 2000; Matthews et al., 1996; Narayana, Doyle, Lai, & Wolinsky, 1998; Pan et al., 1996; Rooney et al., 1997; Sarchielli et al., 1999; Tourbah et al., 1999; van Walderveen, Barkhof et al., 1999). The measurement of N-acetly aspartic acid (NAA) is thought to be a marker of axonal loss, damage or dysfunction. Many studies (Arnold et al., 1992; Arnold et al., 1994; Davie et al., 1997; De Stefano et al., 1995; Husted et al., 1994; Narayana et al., 1998,( Allen & McKeown, 1979; De Stefano et al., 1995; Fu et al., 1998; Husted et al., 1994; Narayana et al., 1998) have shown a reduction in the absolute concentration of NAA or the NAA/Cr ratio in MS lesions. However, pathological(Allen & McKeown, 1979) and quantitative MRSI studies(Armspach, Gounot, Rumbach, & Chambron, 1991; Filippi et al., 1995; Gasperini et al., 1996; Loevner et al., 1995) have shown that in patients with clinically definite MS, abnormalities also occur in the NAWM(Arnold et al., 1992; Davie et al., 1997; Davie et al.,

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MRS in MS, With and Without Interferon Beta 1a Treatment, to Define the Dynamic Changes of Metabolites in the Brain, and to Monitor Disease Progression