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Changes in Cerebral Blood Flow in Patients with Familial Mediterranean Fever
Gözde Çetin1, Uygar Utku2, Nurhan Atilla3
1Department of Internal Diseases, Division of Rheumatology, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey.
Insights
Familial Mediterranean fever (FMF) patients show increased cerebral blood flow velocity, linked to inflammation and potential cerebrovascular disease risk. This study used transcranial Doppler (TCD) to assess blood flow in FMF patients.
Area of Science:
- Neurology
- Vascular Medicine
- Rheumatology
Background:
- Systemic inflammation is linked to atherosclerosis, a major cause of cerebrovascular diseases.
- Familial Mediterranean fever (FMF) is an autoinflammatory disorder characterized by recurrent inflammatory episodes.
- Understanding the vascular impact of FMF is crucial for managing associated risks.
Purpose of the Study:
- To evaluate cerebral blood flow velocity in patients with Familial Mediterranean Fever (FMF).
- To investigate the association between FMF, systemic inflammation, and cerebrovascular hemodynamics.
- To utilize transcranial Doppler (TCD) ultrasonography as a non-invasive tool for this assessment.
Main Methods:
- A cohort of 30 FMF patients and 30 age/sex-matched controls (without atherosclerosis risk factors) were enrolled.
- Transcranial Doppler (TCD) ultrasonography was used to measure middle cerebral artery (MCA) blood flow velocities (peak-systolic, end-diastolic, mean), pulsatility index, and resistance index.
- Measurements were performed by a blinded neurosonologist to ensure objectivity.
Main Results:
- FMF patients exhibited significantly higher C-reactive protein levels compared to controls.
- Bilateral middle cerebral artery (MCA) blood flow velocities were significantly elevated in the FMF group.
- No significant differences in age or sex distribution were noted between the FMF and control groups.
Conclusions:
- Persistent inflammation in FMF patients is associated with increased cerebral blood flow velocities.
- Elevated cerebral blood flow may indicate an increased risk for cerebrovascular complications in FMF.
- This study highlights a potential link between FMF and cerebrovascular disease, warranting further investigation.
Introduction:
It is known that there is a relationship between systemic inflammation and atherosclerosis. Atherosclerosis is one of the best-known causes of cerebrovascular diseases. The aim of this study was to assess cerebral blood flow velocity using transcranial Doppler (TCD) ultrasonography in patients with familial Mediterranean fever (FMF).
Methods:
A total of 30 patients aged from 20 to 50 years with FMF were enrolled in the FMF group consecutively. The control group (non-FMF group) consisted of 30 age- and sex-matched randomly selected patients without FMF who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral peak-systolic, end-diastolic, and mean blood flow velocities in the middle cerebral artery (MCA), values of Gosling's pulsatility index, and values of Pourcelot's resistance index were recorded using TCD ultrasonography by a neurosonologist blinded to the FMF and control groups.
Results:
There were 30 participants in the FMF group in remission (male/female: 4/26, mean age: 34.7±5.9 years) and 30 participants in the control group (male/female: 4/26, mean age: 32.3±4.7 years). C-reactive protein levels and bilateral blood flow velocities in the MCA were significantly higher in the FMF group than in the control group.
Conclusions:
This study suggests that persistent clinical and subclinical inflammation in patients with FMF causes an increase in cerebral blood flow velocities. Our findings provide an insight into this association between FMF and cerebrovascular diseases.
