Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI
Immune-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 rem...
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| Veröffentlicht in: | British journal of haematology 2024-03, Vol.204 (3), p.1005-1016 |
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| creator | Hannan, F Hamilton, J Patriquin, C J Pavenski, K Jurkiewicz, M T Tristao, L Owen, A M Kosalka, P K Deoni, S C L Théberge, J Mandzia, J Huang, S H S Thiessen, J D |
| description | Immune-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 |
| doi_str_mv | 10.1111/bjh.19246 |
| format | Article |
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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.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1111/bjh.19246</identifier><identifier>PMID: 38083818</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>ADAMTS13 Protein ; Cognition ; Cognitive ability ; Cognitive Dysfunction ; Cortex (cingulate) ; Cortex (frontal) ; Cortex (parietal) ; Cortex (temporal) ; Frontal lobe ; Humans ; Magnetic resonance imaging ; Memory ; Mental depression ; Neuroimaging ; Platelet aggregation ; Purpura ; Purpura, Thrombotic Thrombocytopenic - therapy ; Remission ; Substantia alba ; Thrombocytopenic purpura ; Thrombosis ; Thrombotic thrombocytopenic purpura ; White Matter</subject><ispartof>British journal of haematology, 2024-03, Vol.204 (3), p.1005-1016</ispartof><rights>2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-a383a199fa0ad244575181da7164a0a01ce65011fa7196c2842a195b6e04ec653</citedby><cites>FETCH-LOGICAL-c348t-a383a199fa0ad244575181da7164a0a01ce65011fa7196c2842a195b6e04ec653</cites><orcidid>0000-0002-0848-130X ; 0009-0001-8321-683X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38083818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hannan, F</creatorcontrib><creatorcontrib>Hamilton, J</creatorcontrib><creatorcontrib>Patriquin, C J</creatorcontrib><creatorcontrib>Pavenski, K</creatorcontrib><creatorcontrib>Jurkiewicz, M T</creatorcontrib><creatorcontrib>Tristao, L</creatorcontrib><creatorcontrib>Owen, A M</creatorcontrib><creatorcontrib>Kosalka, P K</creatorcontrib><creatorcontrib>Deoni, S C L</creatorcontrib><creatorcontrib>Théberge, J</creatorcontrib><creatorcontrib>Mandzia, J</creatorcontrib><creatorcontrib>Huang, S H S</creatorcontrib><creatorcontrib>Thiessen, J D</creatorcontrib><title>Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>Immune-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.</description><subject>ADAMTS13 Protein</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction</subject><subject>Cortex (cingulate)</subject><subject>Cortex (frontal)</subject><subject>Cortex (parietal)</subject><subject>Cortex (temporal)</subject><subject>Frontal lobe</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Memory</subject><subject>Mental depression</subject><subject>Neuroimaging</subject><subject>Platelet aggregation</subject><subject>Purpura</subject><subject>Purpura, Thrombotic Thrombocytopenic - therapy</subject><subject>Remission</subject><subject>Substantia alba</subject><subject>Thrombocytopenic purpura</subject><subject>Thrombosis</subject><subject>Thrombotic thrombocytopenic purpura</subject><subject>White Matter</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtr3TAQhUVpSW4ei_6BIuimWTjRWA_L2YVLH4GUQEjWRpbHtS62dSPJt9x_H-XVRYcDMxw-hmEOIZ-BnUOui3YznENdCvWBrIArWZQg4CNZMcaqApjQh-Qoxg1jwJmEA3LINdNcg16R3dr_mV1yO6Qd2tHNSN1M0xD81Prk7Pto98lvcc7GdglZhsYl7NzOh3hJ7wekwY9IfU__Di4hnUxKGOiAZkwDNTErYlZH2z39fXd9Qj71Zox4-taPycOP7_frX8XN7c_r9dVNYbnQqTBccwN13RtmulIIWUnQ0JkKlMgWA4tKMoA-O7WypRZlxmWrkAm0SvJj8u117zb4xwVjaiYXLY6jmdEvsSlrVtaqqmSV0a__oRu_hDlflympoBZlxTN19krZ4GMM2Dfb4CYT9g2w5jmMJofRvISR2S9vG5d2wu4f-f59_gTHe4S8</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Hannan, F</creator><creator>Hamilton, J</creator><creator>Patriquin, C J</creator><creator>Pavenski, K</creator><creator>Jurkiewicz, M T</creator><creator>Tristao, L</creator><creator>Owen, A M</creator><creator>Kosalka, P K</creator><creator>Deoni, S C L</creator><creator>Théberge, J</creator><creator>Mandzia, J</creator><creator>Huang, S H S</creator><creator>Thiessen, J D</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0848-130X</orcidid><orcidid>https://orcid.org/0009-0001-8321-683X</orcidid></search><sort><creationdate>202403</creationdate><title>Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI</title><author>Hannan, F ; Hamilton, J ; Patriquin, C J ; Pavenski, K ; Jurkiewicz, M T ; Tristao, L ; Owen, A M ; Kosalka, P K ; Deoni, S C L ; Théberge, J ; Mandzia, J ; Huang, S H S ; Thiessen, J D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-a383a199fa0ad244575181da7164a0a01ce65011fa7196c2842a195b6e04ec653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>ADAMTS13 Protein</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction</topic><topic>Cortex (cingulate)</topic><topic>Cortex (frontal)</topic><topic>Cortex (parietal)</topic><topic>Cortex (temporal)</topic><topic>Frontal lobe</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Memory</topic><topic>Mental depression</topic><topic>Neuroimaging</topic><topic>Platelet aggregation</topic><topic>Purpura</topic><topic>Purpura, Thrombotic Thrombocytopenic - therapy</topic><topic>Remission</topic><topic>Substantia alba</topic><topic>Thrombocytopenic purpura</topic><topic>Thrombosis</topic><topic>Thrombotic thrombocytopenic purpura</topic><topic>White Matter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hannan, F</creatorcontrib><creatorcontrib>Hamilton, J</creatorcontrib><creatorcontrib>Patriquin, C J</creatorcontrib><creatorcontrib>Pavenski, K</creatorcontrib><creatorcontrib>Jurkiewicz, M T</creatorcontrib><creatorcontrib>Tristao, L</creatorcontrib><creatorcontrib>Owen, A M</creatorcontrib><creatorcontrib>Kosalka, P K</creatorcontrib><creatorcontrib>Deoni, S C L</creatorcontrib><creatorcontrib>Théberge, J</creatorcontrib><creatorcontrib>Mandzia, J</creatorcontrib><creatorcontrib>Huang, S H S</creatorcontrib><creatorcontrib>Thiessen, J D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hannan, F</au><au>Hamilton, J</au><au>Patriquin, C J</au><au>Pavenski, K</au><au>Jurkiewicz, M T</au><au>Tristao, L</au><au>Owen, A M</au><au>Kosalka, P K</au><au>Deoni, S C L</au><au>Théberge, J</au><au>Mandzia, J</au><au>Huang, S H S</au><au>Thiessen, J D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2024-03</date><risdate>2024</risdate><volume>204</volume><issue>3</issue><spage>1005</spage><epage>1016</epage><pages>1005-1016</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><abstract>Immune-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. 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| subjects | ADAMTS13 Protein Cognition Cognitive ability Cognitive Dysfunction Cortex (cingulate) Cortex (frontal) Cortex (parietal) Cortex (temporal) Frontal lobe Humans Magnetic resonance imaging Memory Mental depression Neuroimaging Platelet aggregation Purpura Purpura, Thrombotic Thrombocytopenic - therapy Remission Substantia alba Thrombocytopenic purpura Thrombosis Thrombotic thrombocytopenic purpura White Matter |
| title | Cognitive decline in thrombotic thrombocytopenic purpura survivors: The role of white matter health as assessed by MRI |
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