title: Assessment of functional and structural damage in brain parenchyma in patients with vitamin B12 deficiency: A longitudinal perfusion and diffusion tensor imaging study.
abstract: BACKGROUND
  Vitamin B12 deficiency may cause neural tissue damage. Even in advanced stages, conventional imaging of brain usually appears normal in vitamin B12 deficient patients. The aim of this study was to assess the structural and functional changes in brain of patients with vitamin B12 deficiency before and after six weeks of vitamin B12 supplementation using diffusion tensor imaging and pseudo-continuous arterial spin labelling (PCASL).
  
  
  METHODS
  MR imaging including DTI and PCASL and neuropsychological tests (NPT) were performed in 16 patients with vitamin B12 deficiency and 16 controls before and after 6weeks of therapy. Cerebral blood flow (CBF) derived from PCASL and DTI indices was calculated in brain of patients with vitamin B12 deficiency and controls.
  
  
  RESULTS
  Patient with vitamin B12 deficiency showed altered neuropsychological scores and altered CBF as well as fractional anisotropy (FA) values in various brain regions as compared with controls. Both CBF values and neuropsychological scores showed complete reversibility at 6weeks post therapy. Though FA values showed significant recovery, it failed to show complete recovery.
  
  
  CONCLUSIONS
  Our results suggest that micro-structural recovery lags behind functional recovery in patients with vitamin B12 deficiency following therapy and CBF change may be used as an early predictor of complete recovery in patients with B12 deficiency.
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
authors.forename: Bhaswati
authors.initials: B
authors.lastname: Roy
authors.affiliation: Institute of Nuclear Medicine and Allied Science, Delhi, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Trivedi
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: Ravindra K
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: Pradeep K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
authors.forename: Ritu
authors.initials: R
authors.lastname: Tyagi
authors.affiliation: Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India. Electronic address: rakeshree1@gmail.com.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D002560:Cerebrovascular Circulation; D019587:Dietary Supplements; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis* / Q000188:drug therapy*; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D014803:Vitamin B Complex; D014805:Vitamin B 12
keywords: Brain; Cerebral blood flow (CBF); Pseudo-continuous arterial spin labelling (PCASL); Vitamin B12