Gupta Pradeep Kumar, Garg Ravindra Kumar, Gupta Rakesh Kumar, Malhotra Hardeep Singh, Paliwal Vimal Kumar, Rathore Ram Kishore Singh, Verma Rajesh, Singh Maneesh Kumar, Rai Yogita, Pandey Chandra Mani
Department of Neurology, King George's Medical University, Uttar Pradesh, Lucknow, India, 226003.
Neuroradiology. 2014 Feb;56(2):97-106. doi: 10.1007/s00234-013-1306-y. Epub 2013 Dec 10.
Structural imaging of the brain does not demonstrate any changes in a vast majority of patients with vitamin B12 deficiency, even in advanced stages. In this study, we aimed to assess and correlate the functional integrity of the brain fiber tracts using diffusion tensor tractography with neuropsychological examination in patients with vitamin B12 deficiency.
The study was conducted at two tertiary care centers. Thirty-two patients with vitamin B12 deficiency were enrolled and subjected to diffusion tensor tractography, as an extension of diffusion tensor imaging, and neuropsychological assessment. Tests of significance were done to detect changes, pre- and post-vitamin B12 supplementation in the diffusivity parameters (fractional anisotropy and mean diffusivity) and the neuropsychological test scores.
Statistically significant changes were observed in the diffusivity parameters and the neuropsychological test scores between the controls and the patients with vitamin B12deficiency in the pre- and post-treatment phases.
This is the first study to evaluate the diffusion tensor tractography (DTT) parameters in the light of clinical neuropsychological assessment in patients with vitamin B12 deficiency. Utilization of DTT parameters may antedate structural changes and may quantify the neurocognitive deficits.
在绝大多数维生素B12缺乏症患者中，即使处于疾病晚期，脑部结构成像也未显示出任何变化。在本研究中，我们旨在通过扩散张量纤维束成像技术评估维生素B12缺乏症患者脑纤维束的功能完整性，并将其与神经心理学检查结果进行关联。
本研究在两家三级医疗中心进行。招募了32名维生素B12缺乏症患者，对其进行了扩散张量纤维束成像（作为扩散张量成像的延伸）及神经心理学评估。进行显著性检验以检测维生素B12补充前后扩散率参数（各向异性分数和平均扩散率）及神经心理学测试分数的变化。
在治疗前和治疗后阶段，对照组与维生素B12缺乏症患者之间的扩散率参数及神经心理学测试分数存在统计学上的显著变化。
这是第一项根据维生素B12缺乏症患者的临床神经心理学评估来评估扩散张量纤维束成像（DTT）参数的研究。DTT参数的应用可能先于结构变化出现，并可对神经认知缺陷进行量化。
