Quantitative evaluation of cortical thickness in 3T in Behçet's patients without neurological involvement and parenchymal neuro-Behçet's disease.

PURPOSE: To evaluate the spatial distribution of cortical damage in Behcet's Disease (BD) with or without neurological involvement using a cortical thickness measurement approach using three-dimensional T1-weighted imaging. MATERIAL AND METHODS: Fifty-eight BD patients without neurological involvement, twenty-two Parenchymal Neuro-Behçets disease (PNBD) patients, and fifty healthy controls were included in the prospective study. Anatomical 3D T1 images were obtained from all participants using 3T MRI. Using a computational anatomy toolbox (CAT12), we calculated and compared group differences in cortical thickness. RESULTS: Patients with BD without neurological involvement showed cortical thickness reduction in bilateral frontal, bilateral parietal, and right precuneus compared with the healthy controls (HCs) (p < 0.05 FWE corrected [FWEc]). PNBD patients showed frontoparietal cortical thickness reduction when compared with BD patients without neurological involvement (p < 0.05 FWEc). The PNBD patients showed widespread cortical thickness reduction compared with the HC patients (p < 0.05 FWEc). Disease duration was correlated with cortical thickness in the right pericalcarine (p = 0.012 false discovery rate [FDR], r = -0.40), left pericalcarine (p = 0.013 FDR, r = -0.44), and left transverse temporal (p = 0.007 FDR, r = -0.41) regions. CONCLUSION: There is a decrease in cortical thickness in BD patients without neurological involvement. Cortical thickness reduction is more prominent in parenchymal neurobehçet's patients. Cortical thickness shows a negative correlation with disease duration in some regions.

Diagnostic value of ultrasonography in peroneal neuropathy

Background/aim: Peroneal neuropathy at the fibular head (PNFH) is one of the most common entrapment neuropathies. Our aim in this study was to analyze the efficiency of ultrasonography in the diagnosis of PNFH. Materials and methods: The study included 15 peroneal nerves of 12 patients with PNFH and 24 peroneal nerves of 12 healthy controls. PNFH confirmation was based on clinical and electrophysiological findings. All patients and controls underwent ultrasonographic evaluations for peroneal nerves. The cross-sectional area (CSA) was measured. Echogenicity of the nerve was evaluated by comparing it with the adjacent connective tissue deep under the subcutaneous fat. Results: CSA measurement of the peroneal nerve is a valuable diagnostic tool in predicting PNFH (AUC: 0.87, 95% CI: 0.73­1.00, P < 0.01). The CSA cutoff value for diagnosing PNFH was found to be 0.115 cm 2 with 80% sensitivity and 99% specificity. Hypoechoic peroneal nerve in patients with PNFH was very frequent. Conclusion: Ultrasonography is a useful technique in diagnosing PNFH. In addition to clinic and electrophysiological findings, it may improve diagnostic performance.

Multifocal Motor Neuropathy Associated With Infliximab: A Case Report and a Literature Review.

Multifocal motor neuropathy with conduction block (MMN-CB) is purely a motor neuropathy with progressive weakness that is characteristically caused by conduction blocks. Association with antiganglioside antibodies and a good response to immunomodulating therapies suggest an autoimmune etiology. In rare cases, MMN-CB has been reported as an adverse effect of infliximab, a tumor necrosis factor-α blocker. We present a case of MMN-CB due to infliximab in a 45-year-old man with psoriatic arthritis who was exposed to the drug for 2 years because of a delayed diagnosis. We emphasize the possibility of this adverse effect and the importance of detailed electrophysiological examinations, which is supported by a review of the literature.