Lesion distribution pattern of parenchymal Neuro-Behçet's disease using probability mapping

Area of Science:

• Neuroimaging
• Neurology
• Inflammatory Diseases

Background:

• Behçet's disease (BD) is a multisystem inflammatory disorder.
• Neuro-Behçet's disease (NBD) is the most disabling form, often affecting the mesodiencephalic region and brainstem.
• Accurate localization of parenchymal lesions in NBD is crucial for understanding disease progression and patient subgroups.

Purpose of the Study:

• To generate probability maps of parenchymal lesions in NBD.
• To compare lesion locations across patient subgroups with varying clinical and laboratory features.
• To investigate the relationship between lesion localization and disease characteristics.

Main Methods:

• Utilized 66 acute relapse MRI scans from 55 patients with parenchymal NBD (p-NBD).
• Digitalized lesions from T2-weighted axial images using CAD software and transferred them to the ICBM-152 brain template.
• Performed spatial analyses and created subtraction maps to compare patient subgroups.

Main Results:

• Most frequent lesion sites included the rostral pons, mesencephalon, and diencephalic region.
• Females exhibited more frequent brainstem involvement than males.
• Late-onset disease, corticospinal tract lesions, and positive pathergy tests were associated with specific lesion patterns and poorer prognosis.

Conclusions:

• Developed visual probability maps for precise lesion localization in NBD using non-standardized MRIs.
• Established correlations between clinical features (late onset, corticospinal tract lesions) and disease severity/prognosis.
• Identified sex differences in brainstem involvement and potential influence of pathergy test status on lesion lateralization.