title: Proton magnetic resonance spectroscopy reveals central neuroaxonal impairment in systemic sclerosis.
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.
  
  
  CONCLUSIONS
  Evidence of neuroaxonal damage strongly suggests the existence of CNS involvement in SSc.
authors.affiliation: Department of Internal Medicine, Section of Pheumatology, AOUC, University of Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bertinotti
authors.forename: Marzia
authors.initials: M
authors.lastname: Mortilla
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Conforti
authors.forename: Nicola
authors.initials: N
authors.lastname: Colangelo
authors.forename: Francesca
authors.initials: F
authors.lastname: Nacci
authors.forename: Angela
authors.initials: A
authors.lastname: Del Rosso
authors.forename: Claudio
authors.initials: C
authors.lastname: Fonda
authors.forename: Roberto
authors.initials: R
authors.lastname: Casale
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Alberto
authors.initials: A
authors.lastname: Pignone
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis / Q000378:metabolism; D001369:Axons / Q000473:pathology* / Q000502:physiology; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D002794:Choline / Q000032:analysis / Q000378:metabolism; D003401:Creatine / Q000032:analysis / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D045743:Scleroderma, Diffuse / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D045745:Scleroderma, Limited / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline