Filip Pavel, Vojtíšek Lubomír, Jičínská Anna Marie, Valenta Zdeněk, Horák Ondřej, Hrunka Matěj, Mangia Silvia, Michaeli Shalom, Jabandžiev Petr
Department of Neurology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czechia.
Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States.
Front Neurosci. 2024 Dec 3;18:1491770. doi: 10.3389/fnins.2024.1491770. eCollection 2024.
The research on possible cerebral involvement in Crohn's disease (CD) has been largely marginalized and failed to capitalize on recent developments in magnetic resonance imaging (MRI).
This cross-sectional pilot study searches for eventual macrostructural and microstructural brain affection in CD in remission and early after the disease onset.
14 paediatric CD patients and 14 healthy controls underwent structural, diffusion weighted imaging and quantitative relaxation metrics acquisition, both conventional free precession and adiabatic rotating frame transverse and longitudinal relaxation time constants as markers of myelination, iron content and cellular loss.
While no inter-group differences in cortical thickness and relaxation metrics were found, lower mean diffusivity and higher intracellular volume fraction were detected in CD patients over vast cortical regions essential for the regulation of the autonomous nervous system, sensorimotor processing, cognition and behavior, pointing to wide-spread cytotoxic oedema in the absence of demyelination, iron deposition or atrophy.
Although still requiring further validation in longitudinal projects enrolling larger numbers of subjects, this study provides an indication of wide-spread cortical oedema in CD patients very early after the disease onset and sets possible directions for further research.
关于克罗恩病（CD）可能累及大脑的研究在很大程度上被边缘化，且未能利用磁共振成像（MRI）的最新进展。
这项横断面试点研究旨在探寻缓解期及疾病发作早期的CD患者是否存在最终的大脑宏观结构和微观结构病变。
14名儿科CD患者和14名健康对照者接受了结构成像、扩散加权成像以及定量弛豫指标采集，包括传统的自由进动以及绝热旋转框架下的横向和纵向弛豫时间常数，作为髓鞘形成、铁含量和细胞丢失的标志物。
虽然在皮质厚度和弛豫指标方面未发现组间差异，但在CD患者中，在对自主神经系统调节、感觉运动处理、认知和行为至关重要的广大皮质区域检测到较低的平均扩散率和较高的细胞内体积分数，表明在无脱髓鞘、铁沉积或萎缩的情况下存在广泛的细胞毒性水肿。
尽管仍需要在纳入更多受试者的纵向项目中进一步验证，但本研究表明CD患者在疾病发作后很早阶段就存在广泛的皮质水肿，并为进一步研究指明了可能的方向。
