Neuroimaging Findings in Vitamin B₁₂-Deficient Infants With Neurologic Features

Abstract

Background:Vitamin B12 deficiency causes serious neurologic problems among infants. However, its neuroradiologic correlate is still largely obscure. Methodology: This prospective study was conducted on patients aged 6 months to 2 years. All children with proven vitamin B12 deficiency were planned to undergo magnetic resonance imaging (MRI) and magnetic resonance spectroscopy of the brain. Results: A total of 35 patients (63% female) were enrolled. Twenty-six (74%) patients had significant findings on brain MRI scan, commonest of which were thinning of corpus callosum and prominence of extra-axial spaces in 28.6% children, cerebral atrophy in 17%, and diffuse symmetrical hyperintensity of white matter in 5.7% patients. Using logistic regression, it was found that odds of abnormal neuroimaging findings were higher in children below 12 months, in females, and in patients with developmental regression, but none of them were statistically significant. Conclusion: Most of the infants with vitamin B12 deficiency have abnormal neuroimaging findings.

NMR Spectroscopy in Diagnosis and Monitoring of Methylmalonic and Propionic Acidemias

“…Graphic correlations of MRS-determined metabolites' ratios with motor/mental development, as well as their correlations with blood levels of vitamin B 12 and homocysteine, are presented. No correlation between these parameters has been found, although, in 74% of cases, neuroimaging abnormalities were identified [99].…”

“…The studies reviewed above have recorded MRI and MRS spectra at magnetic fields of 1.5 Tesla (64 MHz proton frequency) [36,80,81,83,[85][86][87]89,91,92,[95][96][97]99]. In a few studies, the magnetic field was not mentioned [82,88,90,93], but we may assume that the field was also 1.5 Tesla.…”

“…In terms of the selection of the region for recording the MRS spectra, most of the studies used single-voxel spectroscopy (SVS) with point-resolved spectroscopy (PRESS) or a stimulated echo acquisition mode sequence (STEAM) in the regions selected as abnormal by the MRI images [36,81,86,87,89,90,92,94,96,97,99].…”

“…Most of the patients' mothers were reported to be vegetarian. All patients had neurologic symptoms as well as low serum vitamin B 12 concentrations [99]. Brain images were presented but no MRS spectra were shown.…”