Early primary biliary cholangitis is characterised by brain abnormalities on cerebral magnetic resonance imaging

Autor: Aluel Bak-Bol, Nayna Patel, David Jones, Simon D. Taylor-Robinson, L. Southern, Jin U. Kim, Marzena W. Arridge, Mary M.E. Crossey, George F. Mells, Roger W. Chapman, Julie Fitzpatrick, Vijay P. B. Grover, Graeme J.M. Alexander, Jessica E. Dyson, Adam D. Waldman
Přispěvatelé: Royal College of Physicians, University of London, Friends of Hammersmith Hospital, Imperial College Healthcare NHS Trust, Imperial College Healthcare NHS Trust- BRC Funding, Medical Research Council (MRC)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Grover, V P B, Southern, L, Dyson, J K, Kim, J U, Crossey, M M E, Wylezinska-arridge, M, Patel, N, Fitzpatrick, J A, Bak-bol, A, Waldman, A D, Alexander, G J, Mells, G F, Chapman, R W, Jones, D E J & Taylor-robinson, S D 2016, ' Early primary biliary cholangitis is characterised by brain abnormalities on cerebral magnetic resonance imaging ', Alimentary Pharmacology and Therapeutics, vol. 44, no. 9, pp. 936-945 . https://doi.org/10.1111/apt.13797
Alimentary Pharmacology & Therapeutics
ISSN: 1365-2036
0269-2813
Popis: Background Brain change can occur in primary biliary cholangitis (PBC), potentially as a result of cholestatic and/or inflammatory processes. This change is linked to systemic symptoms of fatigue and cognitive impairment. Aim To identify whether brain change occurs early in PBC. If the change develops early and is progressive, it may explain the difficulty in treating these symptoms. Methods Early disease brain change was explored in 13 patients with newly diagnosed biopsy-proven precirrhotic PBC using magnetisation transfer, diffusion- weighted imaging and 1H magnetic resonance spectroscopy. Results were compared to 17 healthy volunteers. Results Cerebral magnetisation transfer ratios were reduced in early PBC, compared to healthy volunteers, in the thalamus, putamen and head of caudate with no greater reduction in patients with greater symptom severity. Mean apparent diffusion coefficients were increased in the thalamus only. No 1H magnetic resonance spectroscopy abnormalities were seen. Serum manganese levels were elevated in all PBC patients, but no relationship was seen with imaging or symptom parameters. There were no correlations between neuroimaging data, laboratory data, symptom severity scores or age. Conclusions This is the first study to be performed in this precirrhotic patient population, and we have highlighted that neuroimaging changes are present at a much earlier stage than previously demonstrated. The neuroimaging abnormalities suggest that the brain changes seen in PBC occur early in the pathological process, even before significant liver damage has occurred. If such changes are linked to symptom pathogenesis, this could have important implications for the timing of second-line-therapy use.
Databáze: OpenAIRE
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