Differences in brain volume and thickness in patients with pulmonary or spine tuberculosis (TB) compared to non-TB individuals: A cross-sectional retrospective study

Introduction: There is evidence showing that central nervous system TB (CNS-TB) causes meningitis, pachymeningitis, tuberculomas, and granulomas. However, the impact of pulmonary or spine TB on brain morphology and thickness is yet to be documented. TB is associated with increased levels of inflammatory biomarkers in specific brain regions.Objectives: The primary aim of this study was to compare cortical-brain volume and thickness between patients with pulmonary or spine TB and non-TB individuals and investigate the association between inflammatory biomarkers and brain volume or thickness among patients with pulmonary or spine TB.Methods: Participants ranging in age from 18 to 65 years (23 TB patients and 50 healthy controls), who were scanned using 1.5-T MRI at Jazan Hospital, were compared in terms of brain volumes and thicknesses. Brain volume and thickness were measured using FreeSurfer.Results: There were significant differences in the volumes of the bilateral and total amygdala and accumbens areas, right hippocampus and cerebellum, and CSF, and in the thickness of the right pericalcarine area between patients with pulmonary or spine TB and healthy controls. We also found significant associations between inflammatory biomarkers (CRP, WBC, and platelets) and brain volume but not thickness in patients with TB, p < .05.Conclusions: This study is the first to show that pulmonary or spine TB reduces brain size and thickness and suggests that TB may be better understood by considering the correlation between inflammatory biomarkers and brain volumes.