Proton magnetic resonance spectroscopic imaging (1H-MRSI) was used to characterize and follow global gray and white matter (GM/WM) metabolism in 18 early relapsing-remitting multiple sclerosis patients with semi-annual scans over 3 years. Absolute concentrations of N-acetylaspartate (NAA), choline (Cho), creatine (Cr) and myo-inositol (mI) were obtained for all GM and WM in the 360 cm3 1H-MRSI volume-of-interest. Patients average WM Cr, Cho and mI concentrations (over all time points) were 8%, 12% and 11% higher than controls (p≤0.01), while their WM NAA was 6% lower (p=0.07). There were increases with time of patients WM Cr, Cho and NAA (all p0.05).