2024 American Academy of Neurology Abstract Website

Pradeep Kumar Gupta¹, Hardeep Malhotra², Neeraj Kumar², Rakesh Kumar Gupta ⁴, Ravindra Garg⁵, Vinay Suresh³
¹Laboratory of molecular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, ²Department of Neurology, King George's Medical University, ³King George's Medical University, ⁴Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, ⁵Department of Neurology, Department of Neurology,King George Medical University, Lucknow

Objective:

To evaluate the functional integrity of the segmented corpus callosum (CC) by utilizing diffusion tensor tractography (DTT) and biochemical markers associated with vitamin B12 deficiency.

Background:

Vitamin B12 deficiency is known to affect the central nervous system and may lead to serious complications. Conventional brain imaging methods cannot detect signal alterations in most patients with vitamin B12 deficiency, even in the advanced stage. In this study, we aimed to assess the functional integrity of the segmented corpus callosum (CC) by using diffusion tensor tractography (DTT) and biochemical markers related to vitamin B12 deficiency.

Design/Methods:

In this analytical cohort study, we included 40 patients with vitamin B12 deficiency along with age-sex matched controls. The patients underwent DTT as an extension of diffusion tensor imaging. The CC was segmented into seven parts: the rostrum, genu, rostral body, anterior mid-body, posterior mid-body, isthmus, and splenium. Vitamin B12, homocysteine, zinc and copper estimation were done in addition to routine parameters. Changes in pre- and post-vitamin B12 supplementation were evaluated statistically using appropriate tests.

Results:

DTT revealed significant alterations in fractional anisotropy and mean diffusivity in the splenium of the corpus callosum before and after treatment. The mean value of biochemical markers was serum of B12 level (143.67±43.44pg/ml), homocysteine level (19.81±6.98µmol/L), copper level (0.79±.98µg/ml), and zinc level (1.10±.27µg/ml).

Conclusions:

No association was found between the diffusivity parameters and serum biochemistry; however, there were significant changes in parameters involving the splenium during the pre- and the post-treatment phases. We propose that splenium may represent the most susceptible part of the CC in patients with vitamin B12 deficiency.