van Erp Sanne, Ercan Ece, Breedveld Perla, Brakenhoff Lianne, Ghariq Eidrees, Schmid Sophie, van Osch Matthias, van Buchem Mark, Emmer Bart, van der Grond Jeroen, Wolterbeek Ron, Hommes Daniel, Fidder Herma, van der Wee Nic, Huizinga Tom, van der Heijde Désirée, Middelkoop Huub, Ronen Itamar, van der Meulen-de Jong Andrea
Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
World J Gastroenterol. 2017 Feb 14;23(6):1018-1029. doi: 10.3748/wjg.v23.i6.1018.
To evaluate brain involvement in quiescent Crohn's disease (CD) patients with fatigue using quantitative magnetic resonance imaging (MRI).
Multiple MRI techniques were used to assess cerebral changes in 20 quiescent CD patients with fatigue (defined with at least 6 points out of an 11-point numeric rating scale compared with 17 healthy age and gender matched controls without fatigue. Furthermore, mental status was assessed by cognitive functioning, based on the neuropsychological inventory including the different domains global cognitive functioning, memory and executive functioning and in addition mood and quality of life scores. Cognitive functioning and mood status were correlated with MRI findings in the both study groups.
Reduced glutamate + glutamine (Glx = Glu + Gln) concentrations ( = 0.02) and ratios to total creatine ( = 0.02) were found in CD patients compared with controls. Significant increased Cerebral Blood Flow ( = 0.05) was found in CD patients (53.08 ± 6.14 mL/100 g/min) compared with controls (47.60 ± 8.62 mL/100 g/min). CD patients encountered significantly more depressive symptoms ( < 0.001). Cognitive functioning scores related to memory ( = 0.007) and executive functioning ( = 0.02) were lower in CD patients and both scores showed correlation with depression and anxiety. No correlation was found subcortical volumes between CD patients and controls in the T-weighted analysis. In addition, no correlation was found between mental status and MRI findings.
This work shows evidence for perfusion, neurochemical and mental differences in the brain of CD patients with fatigue compared with healthy controls.
使用定量磁共振成像（MRI）评估患有疲劳的静止期克罗恩病（CD）患者的脑部受累情况。
采用多种MRI技术评估20例患有疲劳的静止期CD患者的脑部变化（疲劳定义为在11分数字评定量表中至少得6分），并与17名年龄、性别匹配且无疲劳的健康对照者进行比较。此外，基于包括整体认知功能、记忆和执行功能等不同领域的神经心理学量表以及情绪和生活质量评分，通过认知功能评估精神状态。在两个研究组中，将认知功能和情绪状态与MRI结果进行关联分析。
与对照组相比，CD患者的谷氨酸+谷氨酰胺（Glx = Glu + Gln）浓度降低（ = 0.02），与总肌酸的比率降低（ = 0.02）。与对照组（47.60±8.62 mL/100 g/min）相比，CD患者的脑血流量显著增加（ = 0.05）（53.08±6.14 mL/100 g/min）。CD患者出现明显更多的抑郁症状（ < 0.001）。CD患者与记忆相关的认知功能评分（ = 0.007）和执行功能评分（ = 0.02）较低，且这两个评分均与抑郁和焦虑相关。在T加权分析中，CD患者与对照组之间的皮质下体积无相关性。此外，精神状态与MRI结果之间无相关性。
这项研究表明，与健康对照相比，患有疲劳的CD患者大脑在灌注、神经化学和精神方面存在差异。
