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P139. Asymptomatic brain lesions on cranial magnetic resonance imaging in inflammatory bowel disease

C. Dolapcioglu1, Y. Guleryuzlu1, O. Uygur Bayramicli2, R. Dabak1, E. Ahishali3

1Dr. Lufi Kirdar Kartal Education and Training Hospital, Turkey; 2Maltepe University School of Medicine, Turkey; 3Dr. Lutfi Kirdar Kartal Training and Research Hospital, Department of Gastroenterology, Turkey

Background: A variety of neurological signs and conditions has been reported in association with inflammatory bowel disease (IBD). Such signs and complications that cannot be attributed to a primary neurological disorder are classified among extraintestinal manifestations of the disease. We aimed to examine the frequency and type of asymptomatic neurological involvement in IBD using cranial magnetic resonance imaging and to compare with that of healthy controls.

Methods: Fifty-one IBD patients with no known neurological disease and symptoms were included. Thirty healthy individuals with no known disease other than non-specific headache served as controls. Subjects underwent cranial MRI assessments for gliotic white matter lesions, sinusitis, otitis-mastoiditis, and other brain parenchymal findings.

Results: In IBD group, 37 subjects had ulcerative colitis and 14 had Crohn's disease. Patients and controls were similar with regard to age and gender distribution as well as for the frequency of hypertension, diabetes, dyslipidemia, and cigarette smoking (p > 0.05 for all). Frequencies of gliotic white matter lesions, other brainstem parenchymal lesions, and otitis-mastoiditis were similar in IBD and control patients (p > 0.05), whereas sinusitis was significantly more frequent in IBD patients (56.9% vs. 33.3%, p = 0.041). However, among those subjects with gliotic white matter lesions, the number of such lesions was significantly higher in IBD patients compared to controls (12.75±19.78 vs. 3.20±2.90, p < 0.05). Overall, mild, moderate or severe disease activity was found in 70.6%, 23.5%, and 5.92% of the IBD patients, respectively. The incidences of gliotic white matter lesions and other brain parenchymal lesions, sinusitis, and otitis-mastoiditis did not differ significantly with disease activity or type of the disease (Crohn or ulcerative colitis) (p > 0.05 for all comparisons).

Figure: Frequencies of pathological magnetic resonance imaging findings among IBD patients and controls. *p = 0.041, other comparisons did not reach statistical significance.

Conclusions: The incidence of gliotic white matter lesions seems to be similar in IBD patients and normal healthy individuals. Thus, the detected lesions do not seem to pose clinical significance. However, long-term clinical follow-up data of the lesions are required.