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J Neurol. 2019 Aug;266(8):1937-1943. doi: 10.1007/s00415-019-09359-0. Epub 2019 May 10.

Neuronal loss or dysfunction in patients with early Lyme neuroborreliosis: a proton magnetic resonance spectroscopy study of the brain.

Author information

1
Department of Radiology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276, Białystok, Poland. adam.garkowski@gmail.com.
2
Independent Department, Laboratory of Molecular Imaging, Medical University of Białystok, Białystok, Poland.
3
Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland.
4
Faculty of Applied Informatics and Mathematics, Warsaw University of Life Sciences SGGW, Warsaw, Poland.
5
Department of Radiology, Medical University of Białystok, M. Skłodowskiej-Curie 24A, 15-276, Białystok, Poland.

Abstract

BACKGROUND:

We hypothesized that since Borrelia burgdorferi causes systemic inflammation and infects the brain, it may lead to alterations in cerebral metabolism, as measured by 1H-magnetic resonance spectroscopy (1H-MRS). The purpose of our study was to determine whether 1H-MRS could detect brain metabolite alterations in patients with early Lyme neuroborreliosis (LNB) in normal-appearing brain tissue on the conventional magnetic resonance imaging (MRI).

METHODS:

Twenty-six patients diagnosed with early LNB and twenty-six healthy volunteers as a control group have been involved in the study. All of them underwent routine MRI protocol using 3.0-T MRI scanner. 1H-MRS examinations were performed with repetition time (TR) = 2000 ms, and echo time (TE) = 135 ms. Single voxels were positioned in the anterior and posterior parts of the right and left frontal lobes.

RESULTS:

We found a statistically significant decrease of the N-acetylaspartate/creatine ratio within the anterior part of the right and left frontal lobes (p ≤ 0.001 and p = 0.001 respectively) and in the posterior part of the right and left frontal lobes (p ≤ 0.001 and 0.031) in the patients with LNB.

CONCLUSION:

A significant reduction in NAA/Cr ratio in comparison with the controls suggests the presence of diffuse neuronal loss in patients with early LNB.

KEYWORDS:

1H-magnetic resonance spectroscopy,1H-MRS; Borrelia burgdorferi; Lyme neuroborreliosis; Magnetic resonance spectroscopy

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