Henrik Ullman, Åsa Fowler, Ronny Wickström
Department of Neuroscience, Karolinska Institutet, Sweden.
Neuropediatric Unit, Dept of Women's and Children's Health, Karolinska Institutet, Sweden.
Eur J Paediatr Neurol. 2016 Jan;20(1):125-30. doi: 10.1016/j.ejpn.2015.09.004. Epub 2015 Sep 25.
Tick Borne Encephalitis (TBE) is a viral infection in the central nervous system endemic in Europe and Asia. While pediatric infection may carry a lower risk for serious neurological sequelae compared to adults, a large proportion of children experience long term cognitive problems, most markedly decreased working memory capacity. We explored whether task related functional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) could reveal a biological correlate of status-post TBE in children.
We examined 11 serologically verified pediatric TBE patients with central nervous system involvement with 55 healthy controls with working memory tests and MRI.
The TBE patients showed a prominent deficit in working memory capacity and an increased task related functional MRI signal in working memory related cortical areas during a spatial working memory task performed without sedation. No diffusion differences could be found with DTI, in line with the reported paucity of anatomical abnormalities.
This study is the first to demonstrate functional MRI abnormalities in TBE patients that bears similarity to other patient groups with diffuse neuronal damage.
蜱传脑炎（TBE）是一种在欧洲和亚洲流行的中枢神经系统病毒感染。虽然与成人相比，儿童感染导致严重神经后遗症的风险可能较低，但很大一部分儿童会出现长期认知问题，最明显的是工作记忆能力下降。我们探讨了任务相关功能磁共振成像（MRI）和扩散张量成像（DTI）是否能揭示儿童TBE康复后的生物学关联。
我们对11名经血清学证实的中枢神经系统受累的儿童TBE患者和55名健康对照者进行了工作记忆测试和MRI检查。
在未使用镇静剂的情况下进行空间工作记忆任务时，TBE患者表现出工作记忆能力显著缺陷，且与工作记忆相关的皮质区域中与任务相关的功能性MRI信号增加。DTI未发现扩散差异，这与报道的解剖学异常较少一致。
本研究首次证明TBE患者存在功能性MRI异常，这与其他有弥漫性神经元损伤的患者群体相似。
