Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI

Author:

Hannan F.1ORCID,Hamilton J.1,Patriquin C. J.2,Pavenski K.3,Jurkiewicz M. T.4,Tristao L.4,Owen A. M.56,Kosalka P. K.7,Deoni S. C. L.8910,Théberge J.1410,Mandzia J.5,Huang S. H. S.1710ORCID,Thiessen J. D.1410

Affiliation:

1. Department of Medical Biophysics Western University London Canada

2. Department of Hematology University Health Network Toronto Canada

3. Department of Laboratory Medicine St. Michael's Hospital Toronto Canada

4. Department of Medical Imaging Western University London Canada

5. Department of Clinical Neurological Sciences Western University London Canada

6. Department of Physiology and Pharmacology and Department of Psychology Western University London Canada

7. Department of Medicine, Division of Nephrology Western University London Canada

8. Advanced Baby Imaging Lab Rhode Island Hospital Providence Rhode Island USA

9. Department of Diagnostic Radiology Warren Alpert Medical School at Brown University Providence Rhode Island USA

10. Lawson Health Research Institute London Canada

Abstract

SummaryImmune‐mediated thrombotic thrombocytopenic purpura (iTTP) is a rare condition caused by severe ADAMTS13 deficiency, leading to platelet aggregation and thrombosis. Despite treatment, patients are prone to cognitive impairment and depression. We investigated brain changes in iTTP patients during remission using advanced magnetic resonance imaging (MRI) techniques, correlating these changes with mood and neurocognitive tests. Twenty iTTP patients in remission (30 days post‐haematological remission) were compared with six healthy controls. MRI scans, including standard and specialized sequences, were conducted to assess white matter health. Increased T1 relaxation times were found in the cingulate cortex (p < 0.05), and elevated T2 relaxation times were observed in the cingulate cortex, frontal, parietal and temporal lobes (p < 0.05). Pathological changes in these areas are correlated with impaired cognitive and depressive scores in concentration, short‐term memory and verbal memory. This study highlights persistent white matter damage in iTTP patients, potentially contributing to depression and cognitive impairment. Key regions affected include the frontal lobe and cingulate cortex. These findings have significant implications for the acute and long‐term management of iTTP, suggesting a need for re‐evaluation of treatment approaches during both active phases and remission. Further research is warranted to enhance our understanding of these complexities.

Publisher

Wiley

Subject

Hematology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Shades of Grey—The brain in TTP;British Journal of Haematology;2024-01-16

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