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Journal Article 2008; 29(6): 879-883 PubMed PMID: 19112395 Citation  Keywords:  Adolescent, Analysis of Variance, Anorexia Nervosa:classification, Atrophy:pathology, Brain:pathology, Cushing Syndrome:complications, Female, Humans, Hypogonadism:complications, Hypovolemia:complications, Magnetic Resonance Imaging, Nutritional Status:ph.   

OBJECTIVES: In patients with anorexia nervosa (AN), computer tomography (CT) scanning and/or magnetic resonance imaging (MR) are usually applied to visualise trophic changes of the brain, resulting from considerable malnutrition or general cachexia of the organism. The goal of the study was an evaluation attempt of the degree of trophic changes in the central nervous system (CNS) of girls with AN, following CT scanning of the brain, together with an analysis of selected clinical and diagnostic parameters, related to the trophic changes in question.

PATIENTS & METHODS: The study involved fifty-five (55) female patients with AN. Following CT of the brain - scanning of the cortical sulci - four (4) groups of the patients were identified. The following classification of lesions was applied: Group I - width of cortical sulci < 1.5 mm - standard; Group II - the presence of cortical sulci of width < 1.5 mm and 1.5-3 mm; Group III - width of cortical sulci 1.5-3 mm; Group IV - the presence of cortical sulci of width at 1.5-3 mm and > 3 mm. We did not observe any patient with AN in whom the width of all the cortical sulci was bigger than 3 mm (Group V). In all the groups, clinical parameters, as well as routine laboratory tests and selected hormonal tests, were analysed.

RESULTS: In the performed CT scanning of the head in patients with AN, trophic changes in the CNS (as evaluated by the width of cortical sulci) were revealed in 67.3% of the patients. Among the studied groups, statistically significant differences were found for: body weight loss (BWL), the percent of BWL (BWL%), the BWL to disease duration ratio (BWL/time) and BWL%/time, serum concentrations of potassium, calcium, glucose, total protein and urea, as well as serum concentrations of LH, E2, cortisol, FT3 and FT4. The most pronounced disturbances were observed in Group IV, while the least ones - in Group I.

CONCLUSIONS: In CT scanning of the head, trophic changes in the CNS were observed in girls with AN, measured by the width of cortical sulci. The higher severity of trophic changes in the CNS was associated with higher BWL/time ratio, higher hypercortisolemia, more enhanced hypogonadotrophic hypogonadism, disorders in the peripheral metabolism of the thyroid hormones and with the obtained values of routine laboratory tests, indicating some tendency towards hypovolemia....

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Journal Article 2008; 29(4): 461-466 PubMed PMID: 18766142 Citation  Keywords:  Adult, Atrophy:pathology, Brain:pathology, Disability Evaluation, Disease Progression, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Chronic Progressive:pathology, Multiple Sclerosis, Relapsing-Remitting:pathology, Sta.   

OBJECTIVES: To monitor the interaction between the clinical manifestation of the secondary progressive form of multiple sclerosis (SPMS) expressed in the Expanded Disability Status Scale (EDSS) and abnormal findings in magnetic resonance imaging (MRI) of the brain. To compare a time line of brain atrophy in patients with SPMS, patients with relapsing-remitting multiple sclerosis (RRMS) and the healthy population.

METHODS: Brain atrophy, volume of increased signal lesions on Fluid Attenuated Inversion Recovery Sequence (FLAIR) sequence (s.c.lesion load) and decreased signal lesions on T1 weighted sequence (s.c. black holes) were measured semi-automatically and correlated with EDSS in 12 patients. Further, we compared a time line of brain parenchyma fraction (BPF) loss in patients with SPMS, patients with RRMS and the healthy population.

RESULTS: In patients with SPMS, no statistical correlation was found between lesion load in FLAIR and EDSS and there was also no significant statistical correlation (p=0.1134) between the volume of "black holes" and EDSS. However, we did confirm a significant correlation between increase in brain atrophy and clinical status (p=0.0093). Comparison of patients with SPMS or RRMS and the healthy population revealed that brain atrophy progressed most rapidly in patients with SPMS.

CONCLUSIONS: The presence of a statistically significant difference in BPF loss between patients with SPMS or RRMS and the healthy population merits further study despite the small size of our sample. We postulate that the measurement of brain atrophy could be helpful in determining the transition of RRMS to SPMS and thereby predict the progression of the disease in the future....

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