No evidence of increased cerebrovascular involvement in adult neurologically-asymptomatic β-Thalassaemia. A multicentre multimodal magnetic resonance study
Immacolata Tartaglione
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorCamilla Russo
Neuroradiologia, Università degli Studi di Napoli “Federico II”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorAndrea Elefante
Neuroradiologia, Università degli Studi di Napoli “Federico II”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorMartina Caiazza
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorMaddalena Casale
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorRosanna Di Concilio
Dipartimento di Pediatria, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorAngela Ciancio
Unità Operativa Ematologia - Day Hospital di Talassemia, Ospedale “Madonna delle Grazie”, Matera, Italy
Search for more papers by this authorElisa De Michele
Medicina Trasfusionale AUO “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
Search for more papers by this authorGiovanni Amendola
Dipartimento di Pediatria, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorPaolo Gritti
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorPasquale A. Carafa
Dipartimento di Salute Mentale, Servizio Psichiatrico di Diagnosi e Cura, ASL Salerno, Salerno, Italy
Search for more papers by this authorTeresa Ferrantino
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorAntonella Centanni
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorNoemi Ippolito
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorVioletta Caserta
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorTiziana Oliveto
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorIlaria Granato
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorGianluca Femina
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorFabrizio Esposito
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorSara Ponticorvo
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorAndrea G. Russo
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorAntonietta Canna
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorMario Ermani
Dipartimento di Neuroscienze (DNS), Unità di Statistica e di Informatica, Scuola di Medicina, Università of Padova, Padova, Italy
Search for more papers by this authorMario Cirillo
Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorSilverio Perrotta
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorCorresponding Author
Renzo Manara
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
These authors should be considered co-senior authors.Correspondence: Prof. Renzo Manara, Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Via S. Allende 1, 84081 Baronissi (SA), Italy.
E-mail: [email protected]
Search for more papers by this authorImmacolata Tartaglione
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorCamilla Russo
Neuroradiologia, Università degli Studi di Napoli “Federico II”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorAndrea Elefante
Neuroradiologia, Università degli Studi di Napoli “Federico II”, Napoli, Italy
These authors equally contributed to the study and should be considered first co-authorsSearch for more papers by this authorMartina Caiazza
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorMaddalena Casale
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorRosanna Di Concilio
Dipartimento di Pediatria, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorAngela Ciancio
Unità Operativa Ematologia - Day Hospital di Talassemia, Ospedale “Madonna delle Grazie”, Matera, Italy
Search for more papers by this authorElisa De Michele
Medicina Trasfusionale AUO “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
Search for more papers by this authorGiovanni Amendola
Dipartimento di Pediatria, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorPaolo Gritti
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorPasquale A. Carafa
Dipartimento di Salute Mentale, Servizio Psichiatrico di Diagnosi e Cura, ASL Salerno, Salerno, Italy
Search for more papers by this authorTeresa Ferrantino
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorAntonella Centanni
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorNoemi Ippolito
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorVioletta Caserta
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorTiziana Oliveto
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorIlaria Granato
Ambulatorio di Psicologia, Ospedale “Umberto I”, Nocera Inferiore, Italy
Search for more papers by this authorGianluca Femina
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorFabrizio Esposito
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorSara Ponticorvo
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorAndrea G. Russo
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorAntonietta Canna
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
Search for more papers by this authorMario Ermani
Dipartimento di Neuroscienze (DNS), Unità di Statistica e di Informatica, Scuola di Medicina, Università of Padova, Padova, Italy
Search for more papers by this authorMario Cirillo
Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorSilverio Perrotta
Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
Search for more papers by this authorCorresponding Author
Renzo Manara
Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Salerno, Italy
These authors should be considered co-senior authors.Correspondence: Prof. Renzo Manara, Dipartimento di Medicina e Chirurgia, Scuola Medica Salernitana, Sezione di Neuroscienze, Università di Salerno, Via S. Allende 1, 84081 Baronissi (SA), Italy.
E-mail: [email protected]
Search for more papers by this authorSummary
Multi-factorial causes jeopardize brain integrity in β-thalassaemia. Intracranial parenchymal and vascular changes have been reported among young β-thalassaemia patients but conventional magnetic resonance imaging (MRI) findings are contradictory making early MRI and magnetic resonance angiography (MRA)/venography monitoring a matter of debate.
This study prospectively investigated 75 neurologically asymptomatic β-thalassaemia patients (mean-age 35·2 ± 10·7 years; 52/75 transfusion-dependent; 41/75 splenectomised) using a 3T magnetic resonance scanner; clinical, laboratory and treatment data were also collected. White matter ischaemic-like abnormalities, intracranial artery stenoses, aneurysms and sinus venous thrombosis were compared between patients and 56 healthy controls (mean-age 33·9 ± 10·8 years). No patient or control showed silent territorial or lacunar strokes, intracranial artery stenoses or signs of sinus thrombosis. White matter lesions were found both in patients (35/75, 46·7%) and controls (28/56, 50·0%), without differences in terms of number (4·0 ± 10·6 vs. 4·6 ± 9·1, P = 0·63), size and Fazekas’ Score. Intracranial aneurysms did not differ between patients and controls for incidence rate (7/75, 9·3% vs. 5/56, 8·9%), size and site. Vascular and parenchymal abnormality rate did not differ according to treatments or clinical phenotype. According to this study, asymptomatic β-thalassaemia patients treated according to current guidelines do not seem to carry an increased risk of brain and intracranial vascular changes, thus weakening recommendations for regular brain MRI monitoring.
Conflict of interest
All authors declare no competing financial interests.
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