Chronic Inflammation and Its Association With Neurobehavioral Functions in Pediatric Crohn's Disease: O‐5b

carried out in 30 children age 9-14 years (CD patients: n 1⁄4 11, age-matched healthy controls: n 1⁄4 19). Participants were scanned on a 3 Tesla Siemens Trio MRI system, with a 32-channel head coil. Diffusion-weighted imaging data were acquired using a single shot spin-echo echo planar imaging sequence. A total of 30 diffusion sensitization directions were acquired. Voxel sizes were 1.7 1.7 1.7 mm. Average fractional anisotropy (FA), a measure reflecting white matter fiber density and myelination was computed for several fiber tracts across the brain. All CD patients were scanned during steroid treatment for an acute flare (prednisone dose: M 1⁄4 30.7, SD 1⁄4 9.6 mg/day). Serum markers of inflammation included hsCRP, IL-6, and TNFR2. Demographics, SES and general cognitive ability were comparable between groups. Inflammation was higher in CD patients than healthy controls. RESULTS: CD patients had lower FA than controls in several limbic (temporal) and subcortical fiber tracts including the left and right cingulum angular bundle, the right uncinate and temporal part of the superior longitudinal fasciculus (P<.05 to <.10). Regression models including all subjects accounting for inflammation levels and steroid dose revealed higher inflammation (hsCRP, IL6, TNFR2) but not steroid dose to be a significant predictor (P <.01 to <.05) for lower FA in the cingulum, particularly on the left. Conversely, higher steroid dose but not inflammation predicted lower FA in the right uncinate and temporal part of the superior longitudinal fasciculus (p <.05). Correlations between inflammation and FA adjusted for steroid yielded similar findings for the overall sample and for CD patients only (see table). CONCLUSION(S): Results of this first association between pediatric CD and brain development suggest differential impact of steroids and inflammatory markers on white matter microstructure. The inverse correlation between left cingulum integrity and circulating inflammation is of clinical interest as the cingulum is integral part of the limbic system, connecting prefrontal with medial temporal cortex and thus has been linked to emotion processing, memory and executive functions, all previously associated with inflammation. Further neuroimaging and behavioral studies including CD patients off steroids are warranted to elucidate these initial findings.