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Increased working memory related fMRI signal in children following Tick Borne Encephalitis
Ullman Henrik1, Fowler Åsa2, Wickström Ronny2
1Department of Neuroscience, Karolinska Institutet, Sweden.
Insights
Pediatric Tick Borne Encephalitis (TBE) patients show working memory deficits. Functional MRI reveals brain activity changes in TBE children, indicating potential neuronal damage despite normal DTI scans.
Area of Science:
- Neuroscience
- Infectious Diseases
- Pediatrics
Background:
- Tick Borne Encephalitis (TBE) is a significant central nervous system infection in Europe and Asia.
- Pediatric TBE can lead to long-term cognitive issues, particularly working memory deficits.
- Identifying biological markers for TBE sequelae in children is crucial for understanding disease impact.
Purpose of the Study:
- To investigate if functional MRI (fMRI) and diffusion tensor imaging (DTI) can detect biological correlates of TBE in pediatric patients.
- To assess working memory capacity in children with a history of TBE.
- To explore differences in brain activity and structure between TBE survivors and healthy controls.
Main Methods:
- Functional MRI (fMRI) and Diffusion Tensor Imaging (DTI) were performed on 11 pediatric TBE patients and 55 healthy controls.
- A spatial working memory task was administered during fMRI scans without sedation.
- Working memory tests were used to assess cognitive function in both groups.
Main Results:
- TBE patients exhibited significant working memory deficits compared to controls.
- Increased task-related fMRI signal was observed in working memory-related cortical areas in TBE patients.
- No significant differences in diffusion metrics were found using DTI, consistent with minimal anatomical abnormalities.
Conclusions:
- This study provides the first evidence of functional MRI abnormalities in pediatric TBE patients.
- The observed fMRI alterations suggest diffuse neuronal damage, similar to findings in other neurological conditions.
- fMRI may serve as a valuable tool for detecting functional brain changes in children post-TBE.
Objective:
Tick Borne Encephalitis (TBE) is a viral infection in the central nervous system endemic in Europe and Asia. While pediatric infection may carry a lower risk for serious neurological sequelae compared to adults, a large proportion of children experience long term cognitive problems, most markedly decreased working memory capacity. We explored whether task related functional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) could reveal a biological correlate of status-post TBE in children.
Methods:
We examined 11 serologically verified pediatric TBE patients with central nervous system involvement with 55 healthy controls with working memory tests and MRI.
Results:
The TBE patients showed a prominent deficit in working memory capacity and an increased task related functional MRI signal in working memory related cortical areas during a spatial working memory task performed without sedation. No diffusion differences could be found with DTI, in line with the reported paucity of anatomical abnormalities.
Conclusion:
This study is the first to demonstrate functional MRI abnormalities in TBE patients that bears similarity to other patient groups with diffuse neuronal damage.
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