Abstract
Our aim was to investigate whether neurological impairment in Behçet’s disease (BD) can be assessed by means of proton MRS and whether it can assist in prognosis. We used single-voxel MRS to measure metabolites in regions of normal-appearing pons, basal ganglia and periventricular white matter (PWM) in 32 patients with chronic BD patients with and without neurological deficits and 29 control subjects. Patients had significantly higher N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the basal ganglia than the controls. The Cho/Cr ratio in the PWM was also significantly higher in the patients. MRS enabled clear discrimination of patients and controls and also revealed spectral differences between non-neuro-Behçet’s disease and neuro-Behçet’s disease in the basal ganglia. MRS can be used to assess brain involvement in BD even if structural changes are absent.
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References
Behçet H (1937) Über residivierende, aphtöse, durch ein Virus verursachte Geschwüre am Mund, am Auge und an den Genitalien. Derm Wochenschr 105: 1152–1157
International Study Group for Behcet’s Disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335: 1078–1080
Serdaroglu P, Yazici H, Ozdemir C, et al (1989) Neurologic involvement in Behcet’s syndrome. A prospective study. Arch Neurol 46: 265–269
Yazici H (1993) Behçet’ syndrome. In: Maddison RJ, Isenberg DA, Woo P, Glass DN (eds) Oxford textbook of rheumatology. Oxford Medical Publications, Oxford, pp 884–889
Gerber S, Biondi A, Dormont D, et al (1996) Long-term MR follow-up of cerebral lesions in neuro-Behcet’s disease. Neuroradiology 38: 761–768
Banna M, el-Ramahl K (1991) Neurologic involvement in Behcet disease: imaging findings in 16 patients. AJNR 12: 791–796
Mizukami K, Shiraishi H, Tanaka Y, et al (1992) CNS changes in neuro-Behcet’s disease: CT, MR, and SPECT findings. Comput Med Imaging Graph 16: 401–406
Constantinidis I (2000) MRS methodology. Adv Neurol 83: 235–246
Lenkinski RE (2001) MR spectroscopy: clinical tool or research probe? Acad Radiol 8: 567–570
Hund-Georgiadis M, Norris DG, Guthke T, von Cramon DY (2001) Characterization of cerebral small vessel disease by proton spectroscopy and morphological magnetic resonance. Cerebrovasc Dis 15: 82–90
Howe FA, Maxwell RJ, Saunders DE, et al (1993) Proton spectroscopy in vivo. Magn Reson Q 9: 31–59
Tali ET, Atilla S, Keskin T, et al (1997) MRI in neuro-Behcet’s disease. Neuroradiology 39: 2–6
Patel DV, Neuman MJ, Hier DB (1989) Reversibility of CT and MR findings in neuro-Behcet disease. J Comput Assist Tomogr 13: 669–673
Wechsler B, Dell’lsola B, Vidailhet M, et al (1993) MRI in 31 patients with Behcet’s disease and neurological involvement: prospective study with clinical correlation. J Neurol Neurosurg Psychiatry 56: 793–798
Jennette JC, Falk RJ, Milling DM (1994) Pathogenesis of vasculitis. Semin Neurol 14: 291–299
Hurst RW, Grossman RI (1994) Neuroradiology of central nervous system vasculitis. Semin Neurol 14: 320–340
Kocer N, Islak C, Siva A, et al (1999) CNS involvement in neuro-Behcet syndrome: an MR study. AJNR 20: 1015–1024
Siva A, Kantarci OH, Saip S, et al (2001) Behcet’s disease: diagnostic and prognostic aspects of neurological involvement. J Neurol 248: 95–103
Morrissey SP, Miller DH, Hermaszewski R, et al (1993) Magnetic resonance imaging of the central nervous system in Behcet’s disease. Eur Neurol 33: 287–293
Vignola S, Nobili F, Picco P, et al (2001) Brain perfusion spect in juvenile neuro-Behcet’s disease. J Nucl Med 42: 1151–1157
Coban O, Bahar S, Akman-Demir G, et al (1999) Masked assessment of MRI findings: is it possible to differentiate neuro-Behcet’s disease from other central nervous system diseases? Neuroradiology 41: 255–260
Huang WS, Chiu PY, Kao A, et al (2002) Decreased cerebral blood flow in neuro-Behcet’s syndrome patients with neuropsychiatric manifestations and normal magnetic resonance imaging--a preliminary report. J Neuroimaging 12: 355–359
Avci O, Kutluay E, Argon M, et al (1998) Subclinical cerebral involvement in Behcet’s disease: a SPECT study. Eur J Neurol 5: 49–53
McMenemey WH, Lawrence BJ (1957) Encephalomyelopathy in Behçet’s disease: report of necropsy findings in two cases. Lancet ii: 353–358
Kawakita H, Nishimura M, Satoh Y, et al (1967) Neurological aspects of Behcet’s disease. A case report and clinico-pathological review of the literature in Japan. J Neurol Sci 5: 417–438
Ishino H, Higashi H, Otsuki S (1971) “Neuro-Behçet’s syndrome”. Case report with pathological findings. Folia Psychiatr Neurol Jpn 25: 27–36
Smith JK, Londono A, Castillo M, et al (2002). Proton magnetic resonance spectroscopy of brain-stem lesions. Neuroradiology 44: 825-829
Nussel F, Wegmuller H, Laseyras F, Herschkowitz N, Huber P (1991) Neuro-Behcet: acute and sequential aspects by MRI and MRS. Eur Neurol 31: 399–402
Schubert F, Seifert F, Elster C, et al (2002) Serial 1H-MRS in relapsing-remitting multiple sclerosis: effects of interferon-beta therapy on absolute metabolite concentrations. MAGMA 14: 213–222
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Baysal, T., Ozisik, H.I., Karlidag, R. et al. Proton MRS in Behçet’s disease with and without neurological findings. Neuroradiology 45, 860–864 (2003). https://doi.org/10.1007/s00234-003-1052-7
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DOI: https://doi.org/10.1007/s00234-003-1052-7