Department of Radiology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276, Białystok, Poland.
Independent Department, Laboratory of Molecular Imaging, Medical University of Białystok, Białystok, Poland.
J Neurol. 2019 Aug;266(8):1937-1943. doi: 10.1007/s00415-019-09359-0. Epub 2019 May 10.
We hypothesized that since Borrelia burgdorferi causes systemic inflammation and infects the brain, it may lead to alterations in cerebral metabolism, as measured by H-magnetic resonance spectroscopy (H-MRS). The purpose of our study was to determine whether H-MRS could detect brain metabolite alterations in patients with early Lyme neuroborreliosis (LNB) in normal-appearing brain tissue on the conventional magnetic resonance imaging (MRI).
Twenty-six patients diagnosed with early LNB and twenty-six healthy volunteers as a control group have been involved in the study. All of them underwent routine MRI protocol using 3.0-T MRI scanner. H-MRS examinations were performed with repetition time (TR) = 2000 ms, and echo time (TE) = 135 ms. Single voxels were positioned in the anterior and posterior parts of the right and left frontal lobes.
We found a statistically significant decrease of the N-acetylaspartate/creatine ratio within the anterior part of the right and left frontal lobes (p ≤ 0.001 and p = 0.001 respectively) and in the posterior part of the right and left frontal lobes (p ≤ 0.001 and 0.031) in the patients with LNB.
A significant reduction in NAA/Cr ratio in comparison with the controls suggests the presence of diffuse neuronal loss in patients with early LNB.
我们假设，由于伯氏疏螺旋体引起全身炎症并感染大脑，它可能导致大脑代谢发生变化，这可以通过 H 磁共振波谱（H-MRS）来测量。我们研究的目的是确定在常规磁共振成像（MRI）显示正常的脑实质中，早期莱姆神经Borreliosis（LNB）患者是否可以通过 H-MRS 检测到脑代谢物的变化。
本研究纳入了 26 名诊断为早期 LNB 的患者和 26 名健康志愿者作为对照组。所有患者均接受了 3.0-T MRI 扫描仪的常规 MRI 检查。H-MRS 检查的重复时间（TR）= 2000 毫秒，回波时间（TE）= 135 毫秒。单像素定位在右、左额叶的前、后部分。
我们发现，与对照组相比，LNB 患者的右、左额叶前部分（p ≤ 0.001 和 p = 0.001）和后部分（p ≤ 0.001 和 0.031）的 N-乙酰天冬氨酸/肌酐比值有统计学意义的降低。
与对照组相比，NAA/Cr 比值的显著降低提示早期 LNB 患者存在弥漫性神经元丧失。
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