Gupta Lalit, Gupta Rakesh Kumar, Gupta Pradeep K, Malhotra Hardeep Singh, Saha Indrajit, Garg Ravindra K
Philips India Ltd., Bangalore, India.
Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
Magn Reson Imaging. 2016 Feb;34(2):191-6. doi: 10.1016/j.mri.2015.10.026. Epub 2015 Oct 31.
The resting state functional MRI (rsfMRI) approach is useful to explore the brain's functional organization in health and disease conditions. In this study, using rsfMRI the alteration in brain due to vitamin B12 deficiency and reversibility of these alterations following therapy was studied.
Thirteen patients with clinical and biochemical evidence of vitamin B12 deficiency were recruited in this study. Fifteen age and sex matched healthy controls were also included. Patients and controls were clinically evaluated using neuropsychological test (NPT). The analysis was carried out using regional homogeneity (ReHo) and low frequency oscillations (LFO) of BOLD signals in resting state. Six patients were also evaluated with rsfMRI and NPT after 6 weeks replacement therapy.
ReHo values in patients with vitamin B12 deficiency were significantly lower than controls in the entire cerebrum and the brain networks associated with cognition control, i.e., default mode, cingulo-opercular and fronto-parietal network. There was no significant difference using LFO and it did not show significant correlations with NPT scores. ReHo showed significant correlation with NPT scores. All the 6 patients showed increase in ReHo after replacement therapy.
We conclude that brain networks associated with cognition control are altered in patients with vitamin B12 deficiency, which partially recover following six weeks of replacement therapy. This is the first study to evaluate the rsfMRI in the light of clinical neuropsychological evaluation in patients. rsfMRI may be used as functional biomarker to assess therapeutic response in vitamin B12 deficiency patients.
静息态功能磁共振成像（rsfMRI）方法有助于探索健康和疾病状态下大脑的功能组织。在本研究中，使用rsfMRI研究了维生素B12缺乏导致的大脑改变以及治疗后这些改变的可逆性。
本研究招募了13例有维生素B12缺乏临床和生化证据的患者。还纳入了15名年龄和性别匹配的健康对照者。使用神经心理学测试（NPT）对患者和对照者进行临床评估。在静息状态下，利用BOLD信号的局部一致性（ReHo）和低频振荡（LFO）进行分析。6例患者在接受6周替代治疗后也进行了rsfMRI和NPT评估。
维生素B12缺乏患者的ReHo值在整个大脑以及与认知控制相关的脑网络，即默认模式、扣带回-脑岛和额顶叶网络中均显著低于对照组。使用LFO时无显著差异，且LFO与NPT评分无显著相关性。ReHo与NPT评分显示出显著相关性。所有6例患者在替代治疗后ReHo均升高。
我们得出结论，维生素B12缺乏患者与认知控制相关的脑网络发生改变，在接受六周替代治疗后部分恢复。这是第一项根据患者临床神经心理学评估来评估rsfMRI的研究。rsfMRI可作为评估维生素B12缺乏患者治疗反应的功能生物标志物。
