Introduction: Compared to healthy controls (HCs), individuals with multiple sclerosis (MS) show aberrant brain activation patterns during performance of certain tasks. Such patterns of activity have been interpreted as restructuring of functional connections, i.e. the brain’s ability to change neural networks in response to pathology. However, the relationship between neural damage related to MS and abnormal brain activation is not well understood. Here, we utilized proton magnetic resonance spectroscopy 1H-MRS, a technique sensitive to underlying pathological substrates, to examine neuro metabolite levels in the brain of MS individuals in conjunction with fMRI in order to better understand the relationship between neuropathology and brain activity in MS.Methods: Neuro metabolite levels in pre-selected regions were correlated with brain activity measured with fMRI during a processing speed task in a small sample of 8 individuals with MS and 9 HCs.

Results: A positive correlation between brain activity and the N-acetyl aspartate (NAA) and choline (Cho) levels was noted in specific regions, indicative of neuronal injury and increased membrane turnover, respectively.

Conclusions: Combining fMRI and MRS might be a useful approach for predicting brain pathology and its associated effects on functional brain activation in individuals with MS.