Brain magnetic resonance spectroscopy in Sydenham's chorea and ADHD.
This report presents clinical, laboratory, and neuroimaging findings in a 7-year-old male with Sydenham's chorea associated with attention-deficit hyperactivity disorder. Western immunoblotting revealed serum anti-human basal ganglia tissue antibodies. Magnetic resonance imaging results were normal. Proton magnetic resonance spectroscopic imaging disclosed increased choline/creatine ratio in basal ganglia, frontal, and parieto-occipital areas, and decreased N-acetyl aspartate/creatine ratio in both basal ganglia and frontal areas. Moreover magnetic resonance spectroscopy revealed a peak between 3.6-4.2 ppm of unclear significance. The findings of this study are compared with the previous magnetic resonance spectroscopic studies reported on Sydenham's chorea and attention-deficit hyperactivity disorder. Magnetic spectroscopic imaging suggests an autoimmune basal ganglia damage in the pathogenesis of Sydenham's chorea and fronto-striatal impairment in attention-deficit hyperactivity disorder. In the present case, the previous history of an attention-deficit hyperactivity disorder suggests that this neurobehavioral disorder could be a risk factor for Sydenham's chorea in children with rheumatic fever.
Margari
Lucia
L
Child Neurological and Psychiatric Service, Department of Neurological and Psychiatric Sciences, University of Bari, Italy. l.margari@neurol.uniba.it
Ventura
Patrizia
P
Portoghese
Claudia
C
Presicci
Anna
A
Buttiglione
Maura
M
Di Cuonzo
Franca
F
D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002648:Child; D002794:Choline / Q000378:metabolism; D002819:Chorea / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D003401:Creatine / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline