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...

Full description

Saved in:

Bibliographic Details
Published in:	British journal of haematology Vol. 204; no. 3; pp. 1005 - 1016
Main Authors:	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
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-03-2024
Subjects:	Cognition Cognitive ability Cortex (cingulate) Cortex (frontal) Cortex (parietal) Cortex (temporal) Frontal lobe Magnetic resonance imaging Memory Mental depression Neuroimaging Platelet aggregation Purpura Remission Substantia alba Thrombocytopenic purpura Thrombosis Thrombotic thrombocytopenic purpura magnetic resonance imaging cognitive impairment thrombotic thrombocytopenic purpura myelin water imaging depression
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-1048 1365-2141
DOI:	10.1111/bjh.19246