Proton magnetic resonance spectroscopy reveals central neuroaxonal impairment in systemic sclerosis.

Bertinotti, Luca; Mortilla, Marzia; Conforti, Maria Letizia; Colangelo, Nicola; Nacci, Francesca; Del Rosso, Angela; Fonda, Claudio; Casale, Roberto et al. · J Rheumatol · 2006

case_control · Level III

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Abstract

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

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