Proton magnetic resonance spectroscopy reveals central neuroaxonal impairment in systemic sclerosis

J Rheumatol. 2006 Mar;33(3):546-51.

Abstract

Objective: . Involvement of the central nervous system (CNS) in systemic sclerosis (SSc) is rare. Proton magnetic resonance spectroscopy (1H-MRS) assesses in vivo cerebral metabolites. We investigated the biochemical modifications of the CNS in SSc.

Methods: N-acetylaspartate/creatine ratio (NAA/Cr) and choline/creatine ratio (Cho/Cr) at right centrum semiovale (RCS) and at right basal ganglia (RBG) were evaluated by 1H-MRS in 12 patients with limited (lSSc) and 8 patients with diffuse SSc (dSSc) and 20 control subjects.

Results: With 1H-MRS, a significant reduction of NAA/Cr ratio at RBG (p < 0.02) and at RCS (p < 0.002) was detected in SSc patients. Cho/Cr ratio was increased (p < 0.02) in the RCS, but not in RBG. In patients with lSSc, a significant reduction of NAA/Cr was detected in RCS but not in RBG.

Conclusion: Evidence of neuroaxonal damage strongly suggests the existence of CNS involvement in SSc.

MeSH terms

  • Adult
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / analysis
  • Aspartic Acid / metabolism
  • Axons / pathology*
  • Axons / physiology
  • Biomarkers / analysis
  • Brain / metabolism
  • Brain / pathology*
  • Brain / physiopathology
  • Choline / analysis
  • Choline / metabolism
  • Creatine / analysis
  • Creatine / metabolism
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Scleroderma, Diffuse / diagnosis*
  • Scleroderma, Diffuse / metabolism
  • Scleroderma, Diffuse / physiopathology
  • Scleroderma, Limited / diagnosis*
  • Scleroderma, Limited / metabolism
  • Scleroderma, Limited / physiopathology

Substances

  • Biomarkers
  • Aspartic Acid
  • N-acetylaspartate
  • Creatine
  • Choline