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Analysis of 21 Patients With Alcoholic Marchiafava–Bignami Disease in Chongqing, China

Published online by Cambridge University Press:  29 August 2023

Xiaohui Wu Open the ORCID record for Xiaohui Wu [Opens in a new window] ,
Wenju Li ,
Yuzhu Wang ,
Fu Zhou ,
Xuan Chen  and
Zhi-Qin Xi
Xiaohui Wu
Affiliation:
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Wenju Li
Affiliation:
Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
Yuzhu Wang
Affiliation:
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Fu Zhou
Affiliation:
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Xuan Chen
Affiliation:
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Zhi-Qin Xi*
Affiliation:
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
*
Corresponding author: Z.-Q. Xi; Email: zhiqinxi@hospital.cqmu.edu.cn
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Abstract:

Objective:

This study aimed to investigate the characteristics and prognosis of patients with alcoholic Marchiafava–Bignami disease (MBD), a rare neurological disorder commonly associated with chronic alcoholism, in Chongqing, China.

Methods:

We conducted a retrospective analysis of clinical data from 21 alcoholic MBD patients treated at the First Affiliated Hospital of Chongqing University between 2012 and 2022.

Results:

The study included 21 patients with alcoholic MBD who had a mean age of 59 ± 9.86 years and an average drinking history of 35.48 ± 8.65 years. Acute onset was observed in 14 (66.7%) patients. The primary clinical signs observed were psychiatric disorders (66.7%), altered consciousness (61.9%), cognitive disorders (61.9%), and seizures (42.9%). Magnetic resonance imaging revealed long T1 and long T2 signal changes in the corpus callosum, with lesions predominantly found in the genu (76.2%) and splenium (71.4%) of the corpus callosum. The poor prognosis group demonstrated an increased incidence of altered consciousness (100% vs 50%, P = 0.044), pyramidal signs (80% vs 18.8%, P = 0.011), and pneumonia (100% vs 31.3%, P = 0.007). Patients with a longer drinking history (45.0 ± 10.0 years vs 32.69 ± 5.99 years, p = 0.008) and a lower thiamine dose (p = 0.035) had a poorer prognosis at 1 year.

Conclusions:

This study identified altered consciousness, pyramidal signs, and pneumonia as predictors of a poor prognosis in patients with alcoholic MBD. A longer duration of alcohol consumption and inadequate thiamine supplementation were associated with a poorer prognosis.

Résumé:

RÉSUMÉ:

Analyse de 21 patients atteints de la maladie de Marchiafava-Bignami à Chongqing en Chine.

Objectif :

Cette étude vise à étudier les caractéristiques et le pronostic de patients de Chongqing (Chine) qui sont atteints de la maladie de Marchiafava-Bignami (MMB), un trouble neurologique rare communément associé à l’alcoolisme chronique.

Méthodes :

Nous avons ainsi effectué une analyse rétrospective des données cliniques de 21 patients alcooliques atteints de la MMB et traités au First Affiliated Hospital de l’Université Chongqing entre 2012 et 2022.

Résultats :

On l’a dit, l’étude a porté sur 21 patients atteints de la MMB dont l’âge moyen était de 59 ± 9,86 ans et dont l’historique de consommation d’alcool totalisait 35,48 ± 8,65 ans. Des signes cliniques apparus soudainement ont été observés chez 14 patients (66,7 %). Les principaux signes observés étaient des troubles psychiatriques (66,7 %), une altération de la conscience (61,9 %), des troubles cognitifs (61,9 %) et des crises d’épilepsie (42,9 %). Des examens d’IRM ont par ailleurs révélé des modifications du signal T1 long et T2 long dans le corps calleux avec des lésions prédominantes dans le « genou » (76,2 %) et le splénium (71,4 %) du corps calleux. Le groupe de patients dont le pronostic était mauvais a présenté une incidence accrue de troubles de la conscience (100 % contre 50 %, p = 0,044), de signes d’atteinte pyramidale (80 % contre 18,8 %, p = 0,011) et de pneumonie (100 % contre 31,3 %, p = 0,007). De plus, les patients ayant un historique de consommation d’alcool plus long (45,0 ± 10,0 ans contre 32,69 ± 5,99 ans, p = 0,008) et une dose de thiamine plus faible (p = 0,035) avaient un pronostic plus défavorable au bout d’un an.

Conclusions :

Cette étude a identifié les troubles de la conscience, les signes d’atteinte pyramidale et la pneumonie comme des facteurs prédictifs d’un mauvais pronostic chez les patients atteints de la MMB. Un historique plus long de consommation d’alcool ainsi qu’une supplémentation inadéquate en thiamine ont été associés à un pronostic plus défavorable.

Keywords

Marchiafava–Bignami diseasealcoholicclinical characteristicsprognosisMRI findings
Type
Original Article
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 8
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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