ÖZET

Amaç:

NF1’li olgularda korpus kallozum (KK) hacmi ile bazal ganglionlar, talamus, frontal ve parietal beyaz cevherden elde olunan fractional anisotropy (FA) ve mean diffusity (MD) değerlerinin sağlıklı kontrol grubu ile farklılık gösterip göstermediğinin araştırılmasıdır.

Yöntemler:

NF1 tanısı almış 33 olgu ve 21 sağlıklı kontrol grubu çalışmaya dahil edildi. Her iki grupta KK hacmi ölçüldü. Difüzyon tensör görüntüleme (DTG) ile KK genu ve splenium, globus pallidum, kaudat nükleus, putamen, talamus, parietal ve frontal beyaz cevherden MD ve FA değerleri hesaplanarak karşılaştırma yapıldı.

Bulgular:

NF1’li olgularda KK hacmi belirgin artmıştı. KK genu ve spleniumdan elde olunan MD ve FA değerlerinde kontrol grubuna göre anlamlı farklılık saptandı. Frontal ve parietal beyaz cevher, globus pallidum, putamen, talamus ve kaudat nukleus MD değerleri kontrol grubuna göre anlamlı yüksekti. Kaudat nükleus ve putamende FA değerleri azalırken, globus pallidum FA değerleri ise kontrol grubuna göre yüksekti. KK hacmi ile KK splenium, putamen, talamus ve kaudat nükleus MD değerleri arasında negatif korelasyon vardı.

Sonuç:

NF1’li olgularda tutulum alanlarında MD artışı miyelinizasyonda bozulma ve demiyelinizasyon ile açıklanabilir. FA değerlerindeki heterojenite miyelin kılıflarının parçalanması veya aksonal bozulmaya bağlı mikroyapısal değişiklikler sonucu görülebilir. NF1’li olgularda DTG bulguları hastalığın gelişim sürecini ve klinik bulguların fizyopatolojisini daha detaylı anlamamıza yardımcı olacaktır.

References

Filippi CG, Watts R, Duy LA, Cauley KA. Diffusion-tensor imaging derived metrics of the corpus callosum in children with neurofibromatosis type I. AJR Am J Roentgenol 2013;200:44-9.

Alkan A, Sigirci A, Kutlu R, Ozcan H, Erdem G, Aslan M, et al. Neurofibromatosis type 1: diffusion weighted imaging findings of brain. Eur J Radiol 2005;56:229-34.

Payne JM, Moharir MD, Webster R, North KN. Brain structure and function in neurofibromatosis type 1: current concepts and future directions. J Neurol Neurosurg Psychiatry 2010;81:304-9.

Aydin S, Kurtcan S, Alkan A, Guler S, Filiz M, Yilmaz TF, et al. Relationship between the corpus callosum and neurocognitive disabilities in children with NF-1: diffusion tensor imaging features. Clin Imaging 2016;40:1092-5.

Alkan A, Sarac K, Kutlu R, Yakinci C, Sigirci A, Aslan M, et al. Proton MR spectroscopy features of normal appearing white matter in neurofibromatosis type 1. Magn Reson Imaging 2003;21:1049-53.

Wignall EL, Griffiths PD, Papadakis NG, Wilkinson ID, Wallis LI, Bandmann O, et al. Corpus callosum morphology and microstructure assessed using structural MR imaging and diffusion tensor imaging: initial findings in adults with neurofibromatosis type 1. AJNR Am J Neuroradiol 2010;31:856-61.

Zamboni SL, Loenneker T, Boltshauser E, Martin E, Il’yasov KA. Contribution of diffusion tensor MR imaging in detecting cerebral microstructural changes in adults with neurofibromatosis type 1. AJNR Am J Neuroradiol 2007;28:773-6.

Dubovsky EC, Booth TN, Vezina G, Samango-Sprouse CA, Palmer KM, Brasseux CO. MR imaging of the corpus callosum in pediatric patients with neurofibromatosis type 1. AJNR Am J Neuroradiol 2001;22:190-5.

Moore BD 3rd, Slopis JM, Jackson EF, De Winter AE, Leeds NE. Brain volume in children with neurofibromatosis type 1: relation to neuropsychological status. Neurology 2000;54:914-20.

van Engelen SJ, Krab LC, Moll HA, de Goede-Bolder A, Pluijm SM, Catsman-Berrevoets CE, et al. Quantitative differentiation between healthy and disordered brain matter in patients with neurofibromatosis type I using diffusion tensor imaging. AJNR Am J Neuroradiol 2008;29:816-22.

Pride N, Payne JM, Webster R, Shores EA, Rae C, North KN. Corpus callosum morphology and its relationship to cognitive function in neurofibromatosis type 1. J Child Neurol 2010;25:834-41.

Kayl AE, Moore BD 3rd, Slopis JM, Jackson EF, Leeds NE. Quantitative morphology of the corpus callosum in children with neurofibromatosis and attention-deficit hyperactivity disorder. J Child Neurol 2000;15:90-6.

Wang L, Goldstein FC, Veledar E, Levey AI, Lah JJ, Meltzer CC, et al. Alterations in cortical thickness and white matter integrity in mild cognitive impairment measured by whole-brain cortical thickness mapping and diffusion tensor imaging. AJNR Am J Neuroradiol 2009;30:893-9.

Sheikh SF, Kubal WS, Anderson AW, Mutalik P. Longitudinal evaluation of apparent diffusion coefficient in children with neurofibromatosis type 1. J Comput Assist Tomogr 2003;27:681-6.

Eastwood JD, Fiorella DJ, MacFall JF, Delong DM, Provenzale JM, Greenwood RS. Increased brain apparent diffusion coefficient in children with neurofibromatosis type 1. Radiology 2001;219:354-8.

Ferraz-Filho JR, da Rocha AJ, Muniz MP, Souza AS, Goloni-Bertollo EM, Pavarino-Bertelli EC. Diffusion tensor MR imaging in neurofibromatosis type 1: expanding the knowledge of microstructural brain abnormalities. Pediatr Radiol 2012;42:449-54.

Wei CW, Guo G, Mikulis DJ. Tumor effects on cerebral white matter as characterized by diffusion tensor tractography. Can J Neurol Sci 2007;34:62-8.

Violante IR, Ribeiro MJ, Silva ED, Castelo-Branco M. Gyrification, cortical and subcortical morphometry in neurofibromatosis type 1: an uneven profile of developmental abnormalities. J Neurodev Disord 2013;5:3.

Schmahmann JD, Pandya DN. Disconnection syndromes of basal ganglia, thalamus, and cerebrocerebellar systems. Cortex 2008;44:1037-66.

Levine TM, Materek A, Abel J, O’Donnell M, Cutting LE. Cognitive profile of neurofibromatosis type 1. Semin Pediatr Neurol 2006;13:8-20.

Roy A, Roulin JL, Charbonnier V, Allain P, Fasotti L, Barbarot S, et al. Executive dysfunction in children with neurofibromatosis type 1: a study of action planning. J Int Neuropsychol Soc 2010;16:1056-63.

Grahn JA, Parkinson JA, Owen AM. The cognitive functions of the caudate nucleus. Prog Neurobiol 2008;86:141-55.

Nörofibromatosis Tip 1’li Çocuklarda Korpus Kallozum ve Beyin Parankiminin Mikroyapısal Değerlendirilmesinde Difüzyon Tensör Görüntülemenin Etkinliği

ÖZET

References