Alterations of cerebral blood flow and antiphospholipid antibodies in patients with systemic lupus erythematosus

Objective.In previous studies cerebral blood flow (CBF) was found to be altered in patients with systemic lupus erythematosus (SLE) compared to controls. We investigated the relationships between CBF and clinical data from subjects with SLE with the aim of determining the pathologic factors underlying altered CBF in SLE.Methods.A total of 42 SLE subjects and 19 age- and sex-matched healthy control subjects were studied. Dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) was used to measure CBF. Patients and controls underwent complete clinical and laboratory evaluations in close proximity with their MRI studies.Results.A higher CBF was present in the SLE group and was independently associated in statistical models with higher systolic blood pressure (SBP; p < 0.01). The intensity of the relationships (slope of curve) between CBF and mean arterial blood pressure, diastolic blood pressure, or blood levels of tissue plasminogen activator in the SLE group was significantly blunted relative to the control group.Conclusion.These findings are consistent with an underlying cerebral hyperperfusion in SLE induced by elevated but nonhypertensive levels of SBP. The factors underlying this relationship may be functional and/or structural (atherosclerotic, thrombotic, thromboembolic, or vasculitic) cerebrovascular disease.

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Accuracy of 133-xenon regional cerebral blood flow and quantitative electroencephalography in systemic lupus erythematosus

Lupus ◽

10.1177/096120339600500203 ◽

1996 ◽

Vol 5 (2) ◽

pp. 93-102 ◽

Cited By ~ 8

Author(s):

F. Nobili ◽

G. Rodriguez ◽

A. Arrigo ◽

BM Stubinski ◽

E. Rossi ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Lupus Erythematosus ◽

Regional Cerebral Blood Flow ◽

Quantitative Electroencephalography ◽

Regional Cerebral Blood ◽

Systemic Lupus

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Cerebral Blood Flow in Depressed Patients with Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.100121 ◽

2010 ◽

Vol 37 (9) ◽

pp. 1844-1851 ◽

Cited By ~ 11

Author(s):

GIAMPIERO GIOVACCHINI ◽

MARTA MOSCA ◽

GIANPIERO MANCA ◽

MAURO DELLA PORTA ◽

CLAUDIA NERI ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Lupus Erythematosus ◽

Global Maximum ◽

Emission Computed Tomography ◽

Precentral Gyrus ◽

Women Patients ◽

Systemic Lupus ◽

Depressed Patients

Objective.To characterize the neural circuitry involved in depression associated with systemic lupus erythematosus (SLE), we used single photon emission computed tomography (SPECT) to study regional cerebral blood flow (CBF) in patients with SLE.Methods.SPECT with 99mTc-ethylcysteinate dimer was performed in 30 depressed women patients with SLE, in 14 women patients with SLE and without history of neuropsychiatric disorders, and in 25 healthy women controls. Magnetic resonance imaging was done for all subjects for diagnostic purposes. Analysis of CBF patterns was performed using statistical parametric mapping. Statistical significance was taken at uncorrected p < 0.001 at cluster level.Results.There were no significant differences between depressed and nondepressed patients with SLE for any rheumatologic variable. In comparison to healthy controls, depressed patients with SLE had significantly reduced CBF in bilateral frontal and temporal cortex; global maximum was located in the left precentral gyrus. There were no significant CBF differences between nondepressed patients with SLE and controls. Compared to nondepressed patients with SLE, depressed patients with SLE had significantly lower CBF in 2 clusters that had their local maxima in the right precentral gyrus and in the left superior temporal gyrus. The duration of SLE correlated with decreased perfusion in the left middle and superior frontal gyrus.Conclusion.Depressed patients with SLE have CBF reductions in discrete temporal and frontal regions that may account for depressive symptoms.

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Temporal and spatial changes in cerebral blood flow in neuropsychiatric systemic lupus erythematosus: a subtraction brain spect study

European Journal of Hybrid Imaging ◽

10.1186/s41824-021-00112-3 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Ana Carolina Trevisan ◽

Leonardo Alexandre-Santos ◽

Rodrigo Luppino Assad ◽

Emerson Nobuyuki Itikawa ◽

Felipe Arriva Pitella ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Lupus Erythematosus ◽

Brain Spect ◽

Complement C3 ◽

Systemic Lupus ◽

Neuropsychiatric Systemic Lupus Erythematosus ◽

Spatial Changes ◽

Temporal And Spatial

AbstractThis study was addressed to evaluate the temporal and spatial changes in regional cerebral blood flow (rCBF) of patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Our objective was to correlate the subtracted SPECT coregistered to MRI features (SISCOM) with demographic, clinical and laboratory findings to shed light upon the pathophysiological evolution of the NPSLE. Twenty-six NPSLE patients with MRI and pre- and post-treatment brain SPECT with [99mTc]Tc-ECD. SISCOM features were categorized as improvement, worsening, activation and/or deactivation of rCBF findings. Patients mean age of 43.19 years and 65.38% white were evaluated. The patients mean age at onset of SLE was 26.05 and 42.29 for NPSLE. The mean time between the onset of SLE and first NPSLE symptoms was 05.57 years. The disease has already been initiated as NPSLE in 4 patients. The SLEDAI average score was 31.69 and the SLICC/ACR-DI score was 06.96. The patients underwent an average of 09.23 cyclophosphamide. The SISCOM findings showed functional and pathological states on different brain regions. The rCBF changes were not associated with index scores. There was, however, a trend towards an association between lower SLEDAI scores with improvement and higher SLEDAI with worsening in SISCOM, Also a trend of association between lower SLICC score with improvement, and higher SLICC with worsening. The female gender was predictive of activation and worsening, separately, and deactivation and worsening in a set. Non-white patients were predictive of worsening. The seizure was predictive of deactivation separately, and deactivation and worsening in a set. Finally, normal C3 was a predictor of improvement. The present study showed dynamic brain changes in NPSLE patients. SISCOM technique showed improved rCBF in some brain areas, and worsening, activation and deactivation in others. There were associations between rCBF changes and gender, skin colour and complement C3 and association trends with SLEDAI and SLICC scores.

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Temporal And Spatial Changes In Cerebral Blood Flow In Neuropsychiatric Systemic Lupus Erythematosus: A Subtraction Brain Spect Study.

10.21203/rs.3.rs-646612/v1 ◽

2021 ◽

Author(s):

Ana Carolina Trevisan ◽

Leonardo Alexandre-Santos ◽

Rodrigo Luppino-Assad ◽

Emerson Nobuyuki Itikawa ◽

Felipe Arriva Pitella ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Lupus Erythematosus ◽

Brain Spect ◽

Complement C3 ◽

Systemic Lupus ◽

Neuropsychiatric Systemic Lupus Erythematosus ◽

Spatial Changes ◽

Temporal And Spatial

Abstract This study was addressed to evaluate the temporal and spatial changes in regional cerebral blood flow (rCBF) of patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Our objective was to correlate the subtracted SPECT coregistered to MRI features (SISCOM) with demographic, clinical and laboratory findings to shed light upon the pathophysiological evolution of the NPSLE. Twenty-six NPSLE patients with MRI and pre and post-treatment brain SPECT with [99mTc]Tc-ECD. SISCOM features were categorized as improvement,worsening, activation and/or deactivation of rCBF findings. Patients mean age of 43.19 years and 65.38% white were evaluated. The patients mean age at onset of SLE was 26.05 and 42.29 for NPSLE. The mean time between the onset of SLE and first NPSLE symptoms was 5.57 years. The disease has already been initiated as NPSLE in 4 patients. The SLEDAI average score was 31.69 and the SLICC/ACR-DI score was 6.96. The patients underwent an average of 9.23 cyclophosphamide. The SISCOM findings showed functional and pathological states on different brain regions. The rCBF changes were not associated with index scores. There was, however, a trend towards an association between lower SLEDAI scores with improvement and higher SLEDAI with worsening in SISCOM. Also, a trend of association between lower SLICC score with improvement, and higher SLICC with worsening. The female gender was predictive of activation and worsening, separately, and deactivation and worsening in a set. Non-white patients were predictive of worsening. The seizure was predictive of deactivation separately, and deactivation and worsening in a set. Finally, normal C3 was a predictor of improvement. The present study showed dynamic brain changes in NPSLE patients. SISCOM technique showed improved rCBF in some brain areas, and worsening, activation and deactivation in anothers. There were associations between rCBF changes and gender, skin colour and complement C3, and association trends with SLEDAI and SLICC scores.

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