scholarly journals Diminished white matter integrity in patients with systemic lupus erythematosus

2014 ◽  
Vol 5 ◽  
pp. 291-297 ◽  
Author(s):  
Tobias Schmidt-Wilcke ◽  
Patricia Cagnoli ◽  
Page Wang ◽  
Thomas Schultz ◽  
Anne Lotz ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
White Matter Integrity ◽  
Systemic Lupus

scholarly journals White-matter integrity in patients with systemic lupus erythematosus and memory deficits

2018 ◽  
Vol 31 (6) ◽  
pp. 587-595 ◽  
Author(s):  
Diogo G Corrêa ◽  
Nicolle Zimmermann ◽  
Rafael S Borges ◽  
Denis B Pereira ◽  
Thomas M Doring ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
Diffusion Tensor ◽  
Memory Deficits ◽  
Memory Deficit ◽  
Cognitive Domain ◽  
White Matter Integrity ◽  
Systemic Lupus ◽  
The Mean

Purpose Cognitive dysfunction is common in neuropsychiatric systemic lupus erythematosus (SLE). Memory is a commonly affected cognitive domain. Clinically, however, it is difficult to detect memory deficits. The objective of this study is to evaluate whether normal controls and SLE patients with and without memory deficit differ in terms of white-matter integrity. Methods Twenty SLE patients with memory deficit were compared to 47 SLE patients without memory deficit and 22 sex-, age-, and education-matched control individuals. Diffusion tensor imaging (DTI) was performed in a 1.5-Tesla scanner. For tract-based spatial statistics analysis, a white-matter skeleton was created. A permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were also projected onto the mean FA skeleton. Results Compared to controls, SLE patients with and without memory deficit had decreased FA in: bilateral anterior thalamic radiation, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, corticospinal tract, genu, and body of the corpus callosum. SLE patients with and without memory deficit also presented increased MD and RD values compared to controls in these areas. Comparison between SLE patients with and without memory deficit did not present significant differences in DTI parameters. Conclusion DTI can detect extensive abnormalities in the normal-appearing white matter of SLE patients with and without memory deficit, compared to controls. However, there was no difference, in terms of white-matter integrity, between the groups of SLE patients.

MR Diffusion Tractography to Identify and Characterize Microstructural White Matter Tract Changes in Systemic Lupus Erythematosus Patients

2016 ◽  
Vol 23 (11) ◽  
pp. 1431-1440 ◽  
Author(s):  
RaviK. Shastri ◽  
GaurangV. Shah ◽  
Page Wang ◽  
Patricia Cagnoli ◽  
Tobias Schmidt-Wilcke ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
White Matter Tract ◽  
Systemic Lupus ◽  
Diffusion Tractography ◽  
Mr Diffusion

scholarly journals Jaw Dystonia and Reversible Basal Ganglia Changes as an Initial Presentation of Systemic Lupus Erythematosus

2017 ◽  
Vol 8 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Meghan Romba ◽  
Yujie Wang ◽  
Shu-Ching Hu ◽  
Sandeep Khot
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Basal Ganglia ◽  
Brain Imaging ◽  
Lupus Erythematosus ◽  
Subcortical White Matter ◽  
High Dose ◽  
Neuropsychiatric Lupus ◽  
Systemic Lupus ◽  
Traditional Treatment

Dystonia as a manifestation of neuropsychiatric lupus erythematosus (NPSLE) is uncommon. We report a 25-year-old woman who experienced progressive confusion, reduced speech, and difficulty opening her mouth approximately 2 weeks after development of a facial rash. Brain imaging showed bilateral, symmetric signal abnormalities within the basal ganglia and subcortical white matter. Despite treatment with high-dose steroids, she continued to have difficulty speaking with evidence of jaw dystonia on examination. Jaw dystonia rapidly improved with the initiation of levodopa. Repeat evaluation 3 months later exhibited the absence of jaw dystonia and near resolution of the imaging abnormalities. Our patient demonstrated a unique presentation with jaw dystonia refractory to traditional treatment for NPSLE. Such a presentation likely represents a severe variant of NPSLE requiring both immunosuppressive and symptomatic therapies.

White Matter Microstructure and Cognition in Non-neuropsychiatric Systemic Lupus Erythematosus

2009 ◽  
Vol 22 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Christopher M. Filley ◽  
Elizabeth Kozora ◽  
Mark S. Brown ◽  
David E. Miller ◽  
Sterling G. West ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus ◽  
White Matter Microstructure

scholarly journals Functional impairments in white matter syndrome of neuropsychiatric systemic lupus erythematosus are similar to those observed in patients with multiple sclerosis

2012 ◽  
Vol 70 (10) ◽  
pp. 769-773 ◽  
Author(s):  
Denise Sisterolli-Diniz ◽  
Aline de Oliveira ◽  
Daiany Silva de Paula ◽  
Rosangela Vieira Rodrigues ◽  
Nilzio Antônio da Silva
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
Signs And Symptoms ◽  
Functional System ◽  
Functional Impairments ◽  
Systemic Lupus ◽  
Symptoms Of Depression ◽  
Neuropsychiatric Systemic Lupus Erythematosus

OBJECTIVE: In order to compare white matter syndrome of neuropsychiatric systemic lupus erythematosus (NPSLE) and multiple sclerosis (MS), an assessment on demographic, medical history, and clinical data was proposed. METHODS: Sixty-four patients with NPSLE and 178 with MS answered a questionnaire and were evaluated regarding functional system, expanded disability status scale (EDSS), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). RESULTS: The prevalence of autoimmune diseases and altered consciousness was similar in both groups, however it was higher than in the general population. Systemic signs and symptoms occurred from 2.9 to 61.9% of the MS cases, while neurological signs and symptoms occurred in 9.4 to 76.4% of the NPSLE ones. The motor, visual, and mental systems were the most affected in both diseases. The BDI in NPSLE had higher scores and the BAI in MS. CONCLUSIONS: The functional impairments in NPSLE were similar to those of MS, although greater impairment of the functional systems of cerebellar, sensitivity, and sphincters occurred in MS cases, and greater symptoms of depression, anxiety, and headache also occurred in it.

scholarly journals Are serum autoantibodies associated with brain changes in systemic lupus erythematosus? MRI data from the Leiden NP-SLE cohort

Lupus ◽  
2018 ◽  
Vol 28 (1) ◽  
pp. 94-103 ◽  
Author(s):  
C. Magro-Checa ◽  
S. Kumar ◽  
S. Ramiro ◽  
L.J. Beaart-van de Voorde ◽  
J. Eikenboom ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Sensitivity Analysis ◽  
White Matter ◽  
Basal Ganglia ◽  
Lupus Erythematosus ◽  
Brain Abnormalities ◽  
Systemic Lupus ◽  
Lacunar Infarcts ◽  
Mri Brain ◽  
Brain Changes

Objective The effect of serum autoantibodies on the brain of systemic lupus erythematosus (SLE) patients remains unclear. We investigated whether serum autoantibodies, individually and assessed in groups, are associated with specific brain-MRI abnormalities or whether these structural changes are associated with other SLE-related or traditional cardiovascular disease risk factors. Methods All patients underwent brain 3Tesla-MRI. White matter hyperintensities (WMHs), ischemic lesions, inflammatory-like lesions and cerebral atrophy were scored. Serum autoantibodies analyzed included lupus anticoagulant (LAC), anticardiolipine (aCL) IgG and IgM (first 3 also grouped into antiphospholipid autoantibodies (aPL)), anti-dsDNA, anti-SSA, anti-SSB, anti-RNP, and anti-Sm (the latter 5 grouped into SLE-related autoantibodies). Associations were assessed using logistic regression analysis adjusted for potential confounders. Furthermore, a sensitivity analysis including anti-Beta2 glycoprotein-1 antibodies (anti-β2GP1) in the aPL group was performed and the potential modification role of the neuropsychiatric clinical status in the model was assessed. Results 325 patients (mean age 42 years (SD 14), 89% female) were included. The following MRI-brain abnormalities were found: WMHs (71%), lacunar infarcts (21%), gliosis (11%), micro-hemorrhages (5%), large hemorrhages (2%), inflammatory-like lesions (6%) and atrophy (14%). No associations were found between individual or total SLE-related autoantibodies and inflammatory-like lesions. A higher number of positive aPL was associated with lacunar infarcts (OR 1.37 (95%CI 1.02–1.99) and gliosis (OR 2.15 (1.37–3.37)). LAC was associated with lacunar infarcts in white matter (OR 3.38 (1.32–8.68)) and atrophy (OR 2.49 (1.01–6.15)), and aCL IgG with gliosis (OR 2.71 (1.05–7.02)). Among other variables, SLE patients with hypertension presented a higher chance for WMHs (OR 5.61 (2.52–12.48)) and lacunar infarcts in WM (OR 2.52 (1.10–5.74)) and basal ganglia (OR 8.34 (2.19–31.70)), while cumulative SLE-damage was correlated with lacunar infarcts in WM (OR 1.43 (1.07–1.90)), basal ganglia (OR 1.72 (1.18–2.51)) and cerebellum (OR 1.79 (1.33–2.41)). These associations were confirmed in the sensitivity analysis. Conclusions Brain abnormalities in SLE represent different underlying pathogenic mechanisms. aPL are associated with ischemic brain changes in SLE, while the presence of SLE-related serum autoantibodies is not related to inflammatory-like lesions. Hypertension and cumulative SLE-damage associate with ischemic MRI-brain changes in SLE, suggesting the importance of accelerated atherosclerosis in this process.

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