title: Cerebral magnetic resonance imaging in quiescent Crohn's disease patients with fatigue.
abstract: OBJECTIVE
  To evaluate brain involvement in quiescent Crohn's disease (CD) patients with fatigue using quantitative magnetic resonance imaging (MRI).
  
  
  METHODS
  Multiple MRI techniques were used to assess cerebral changes in 20 quiescent CD patients with fatigue (defined with at least 6 points out of an 11-point numeric rating scale compared with 17 healthy age and gender matched controls without fatigue. Furthermore, mental status was assessed by cognitive functioning, based on the neuropsychological inventory including the different domains global cognitive functioning, memory and executive functioning and in addition mood and quality of life scores. Cognitive functioning and mood status were correlated with MRI findings in the both study groups.
  
  
  RESULTS
  Reduced glutamate + glutamine (Glx = Glu + Gln) concentrations (P= 0.02) and ratios to total creatine (P= 0.02) were found in CD patients compared with controls. Significant increased Cerebral Blood Flow (P= 0.05) was found in CD patients (53.08 ± 6.14 mL/100 g/min) compared with controls (47.60 ± 8.62 mL/100 g/min). CD patients encountered significantly more depressive symptoms (P< 0.001). Cognitive functioning scores related to memory (P= 0.007) and executive functioning (P= 0.02) were lower in CD patients and both scores showed correlation with depression and anxiety. No correlation was found subcortical volumes between CD patients and controls in the T1-weighted analysis. In addition, no correlation was found between mental status and MRI findings.
  
  
  CONCLUSIONS
  This work shows evidence for perfusion, neurochemical and mental differences in the brain of CD patients with fatigue compared with healthy controls.
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Sanne
authors.initials: S
authors.lastname: van Erp
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Ece
authors.initials: E
authors.lastname: Ercan
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Perla
authors.initials: P
authors.lastname: Breedveld
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Lianne
authors.initials: L
authors.lastname: Brakenhoff
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Eidrees
authors.initials: E
authors.lastname: Ghariq
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Sophie
authors.initials: S
authors.lastname: Schmid
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Matthias
authors.initials: M
authors.lastname: van Osch
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van Buchem
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Emmer
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hommes
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Herma
authors.initials: H
authors.lastname: Fidder
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Nic
authors.initials: N
authors.lastname: van der Wee
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Huizinga
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Huub
authors.initials: H
authors.lastname: Middelkoop
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Itamar
authors.initials: I
authors.lastname: Ronen
authors.affiliation: Sanne van Erp, Lianne Brakenhoff, Daniel Hommes, Andrea van der Meulen-de Jong, Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Zuid-Holland 2333 ZA, the Netherlands.
authors.forename: Andrea
authors.initials: A
authors.lastname: van der Meulen-de Jong
mesh_terms: D000328:Adult; D000339:Affect; D001007:Anxiety / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D003071:Cognition; D003401:Creatine / Q000097:blood; D003424:Crohn Disease / Q000097:blood / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000503:physiopathology; D056344:Executive Function; D005221:Fatigue / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D018698:Glutamic Acid / Q000097:blood; D005973:Glutamine / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011788:Quality of Life; D055815:Young Adult
chemical_list: D005973:Glutamine; D018698:Glutamic Acid; D003401:Creatine
keywords: Cognition; Crohn’s disease; Fatigue; Magnetic resonance imaging; Systemic inflammation