Article

Acute paralytic poliomyelitis is associated with encephalitis. Early
brain inflammation may produce permanent neuronal injury with brain atrophy,
which may result in symptoms such as fatigue. Brain volume has not been assessed
in postpoliomyelitis syndrome (PPS). OBJECTIVE: To determine whether brain volume
is decreased compared with that in normal controls, and whether brain volume is
associated with fatigue in patients with PPS. DESIGN: A cross-sectional study.
SETTING: Tertiary university-affiliated hospital postpolio and multiple sclerosis
(MS) clinics. PARTICIPANTS: Forty-nine ambulatory patients with PPS, 28 normal
controls, and 53 ambulatory patients with MS. METHODS: We studied the brains of
all study subjects with magnetic resonance imaging by using a 1.5 T Siemens
Sonata machine. The subjects completed the Fatigue Severity Scale. Multivariable
linear regression models were computed to evaluate the contribution of PPS and MS
compared with controls to explain brain volume. MAIN OUTCOME MEASUREMENTS:
Normalized brain volume (NBV) was assessed with the automated program Structured
Image Evaluation, using Normalization, of Atrophy method from the acquired
magnetic resonance images. This method may miss brainstem atrophy. RESULTS:
Technically adequate NBV measurements were available for 42 patients with PPS, 27
controls, and 49 patients with MS. The mean (standard deviation) age was 60.9 +/-
7.6 years for patients with PPS, 47.0 +/- 14.6 years for controls, and 46.2 +/-
9.4 years for patients with MS. In a multivariable model adjusted for age and
gender, NBV was not significantly different in patients with PPS compared with
that in controls (P = .28). As expected, when using a similar model for patients
with MS, NBV was significantly decreased compared with that in controls (P =
.006). There was no significant association between NBV and fatigue in subjects
with PPS (Spearman rho = 0.23; P = .19). CONCLUSIONS: No significant whole-brain
atrophy was found, and no association of brain volume with fatigue in PPS. Brain
atrophy was confirmed in MS. It is possible that brainstem atrophy was not
recognized by this study.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS