Mapping White Matter Degeneration in iTTP Survivors: A Diffusion Tensor Imaging Study

Motivation: There is a need to better understand the neurological impacts on immune-mediated thrombotic thrombocytopenic purpura (iTTP) survivors, who face increased risks of cognitive impairment and cerebrovascular disease, despite current treatment efforts. Goal(s): This study investigated whether degeneration of brain WM microstructure, as assessed by diffusion tensor imaging (DTI), may be related to cognitive decline in iTTP patients. Approach: DTI measurements in WM regions linked to cognition were compared between 23 iTTP patients at 30 days post-remission and 22 healthy controls alongside cognitive assessments. Results: iTTP survivors showed evidence of significant WM damage and cognitive deficits, particularly in short-term memory and concentration domains. Impact: This study highlights the importance of long-term neurological monitoring in iTTP survivors demonstrating significant white matter damage linked to cognitive decline. The findings support the notion of exploring early interventions to preserve cognitive function through routine neuroimaging and targeted therapies.