Proton magnetic resonance spectroscopy reveals central neuroaxonal impairment in systemic sclerosis.
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.
Bertinotti
Luca
L
Department of Internal Medicine, Section of Pheumatology, AOUC, University of Florence, Italy.
Mortilla
Marzia
M
Conforti
Maria Letizia
ML
Colangelo
Nicola
N
Nacci
Francesca
F
Del Rosso
Angela
A
Fonda
Claudio
C
Casale
Roberto
R
Matucci-Cerinic
Marco
M
Pignone
Alberto
A
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
D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline