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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Diffusion-weighted imaging in Sydenham's chorea.

Hakan Gumus1, Gulsum Gumus, Huseyin Per

  • 1Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey. hakgumus@erciyes.edu.tr

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|August 29, 2012
PubMed
Summary

Diffusion-weighted MRI revealed lower apparent diffusion coefficients (ADCs) in the caudate nucleus of children with Sydenham's chorea, suggesting inflammation. Treatment normalized these diffusion-weighted imaging values.

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Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Sydenham's chorea is a childhood disorder characterized by involuntary movements.
  • Basal ganglia involvement is suspected in the pathophysiology of Sydenham's chorea.
  • Diffusion-weighted magnetic resonance imaging (DW-MRI) can detect subtle changes in brain tissue.

Purpose of the Study:

  • To investigate changes in the caudate nucleus using DW-MRI in children with Sydenham's chorea.
  • To assess the effect of prednisone treatment on caudate nucleus diffusion parameters.

Main Methods:

  • DW-MRI was performed on 13 children with Sydenham's chorea and 13 healthy controls before and 2 months after 4 weeks of prednisone treatment.
  • Apparent diffusion coefficients (ADCs) were calculated for the right and left caudate nucleus.

Main Results:

  • ADC values in both the left and right caudate nucleus were significantly lower before treatment compared to 2 months after treatment.
  • ADC values for the left caudate nucleus increased from 0.69±0.038 to 0.95±0.04.
  • ADC values for the right caudate nucleus increased from 0.72±0.06×10⁻³ to 0.93±0.04×10⁻³.

Conclusions:

  • Despite normal conventional MRI findings, reduced ADC values in the caudate nucleus suggest autoimmune inflammation in Sydenham's chorea.
  • Prednisone treatment led to a normalization of ADC values, supporting the role of inflammation.