Migraine in patients with systemic lupus erythematosus is associated with reduced cerebral grey matter volume but not with measures of glial activation or anti-NR2 or anti-P antibodies

Cognitive dysfunction is one of the five psychiatric syndromes recognised by the American College of Rheumatologists neuropsychiatric lupus nomenclature committee. Cognitive dysfunction affects 20%–80% of systemic lupus erythematosus patients with and without overt central nervous system involvement. Specific cognitive dysfunction associated with systemic lupus erythematosus includes impairment in attention, memory and visuospatial process. Besides disease activity and vascular risk factors, the neuropathology behind cognitive dysfunction in systemic lupus erythematosus is a result of dysfunction involving the immune cells, cytokines, chemokines and autoantibodies (Abs), as well as volume reduction in the white matter and grey matter. In this review, we will discuss the challenges of using traditional neuropsychological assessment to assess cognitive function in clinical practice, the limitations of conventional neuroimaging methods, the controversies of using corticosteroids, other pharmacological treatments and non-pharmacological interventions to treat cognitive dysfunction associated with systemic lupus erythematosus.

Download Full-text

13 – Early evidence of cerebral grey matter volume changed after treatment in neuroleptic naïve, newly diagnosed schizophrenia

Schizophrenia Research ◽

10.1016/j.schres.2007.12.080 ◽

2008 ◽

Vol 98 ◽

pp. 38

Author(s):

Y. Deng ◽

H.S. Merali ◽

C. Cheung ◽

E.Y.H. Chen ◽

V. Cheung ◽

...

Keyword(s):

Grey Matter ◽

Grey Matter Volume ◽

Newly Diagnosed ◽

Matter Volume ◽

Early Evidence ◽

Cerebral Grey Matter

Download Full-text

SAT0588 Early Cerebral Volume Reduction and Regional Improvement of Prefrontal Gray Matter Volume with Reduced Lupus Disease Activity in Patients with Newly-Diagnosed Non-Neuropsychiatric Systemic Lupus Erythematosus (SLE)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.3079 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 874.2-874

Author(s):

A. Mak ◽

R.C. Ho ◽

H.Y. Tng ◽

H.L. Koh ◽

J.S. Chong ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Disease Activity ◽

Gray Matter ◽

Lupus Erythematosus ◽

Gray Matter Volume ◽

Volume Reduction ◽

Newly Diagnosed ◽

Systemic Lupus ◽

Matter Volume ◽

Lupus Disease Activity

Download Full-text

Multi-voxel proton magnetic resonance spectroscopy changes in neuropsychiatric lupus patients

South African Journal of Radiology ◽

10.4102/sajr.v20i1.974 ◽

2016 ◽

Vol 20 (1) ◽

Author(s):

Page L. Wang ◽

Richard E. Harris ◽

Thomas L. Chenevert ◽

William J. McCune ◽

Pia C. Sundgren

Keyword(s):

Systemic Lupus Erythematosus ◽

White Matter ◽

Magnetic Resonance ◽

Lupus Erythematosus ◽

Grey Matter ◽

Neuropsychiatric Symptoms ◽

Resonance Spectroscopy ◽

Systemic Lupus ◽

Left Posterior ◽

Posterior Insula

Purpose: In this prospective study, we used 2D chemical shift imaging (CSI), a multi-voxel proton spectroscopy technique, to evaluate the brain metabolites on conventional magnetic resonance imaging (MRI) in normal-appearing white and grey matter in systemic lupus erythematosus (SLE) patients with neuropsychiatric symptoms (NPSLE); without neuropsychiatric symptoms (non-NPSLE); and healthy controls (HCs). Our objective was to find metabolites that discriminated NPSLE patients from the non-NPSLE and HC cohorts.Materials and methods: The study included 23 NPSLE patients, 20 non-NPSLE patients, and 21 HCs. A clinical assessment including the SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics (SLICC) scores was conducted. All patients underwent conventional MRI and 2D CSI technique to acquire the following metabolic ratios: NAA/Cr, Cho/Cr, and Cho/NAA in the anterior and posterior insula, anterior frontal and parietal white and grey matter, thalamus, basal ganglia, and occipital grey matter.Results: In terms of metabolic differences, the NPSLE patients had significant differences compared with the non-NPSLE and HC groups in the: left posterior insula (increased Cho/NAA; p = 0.008), right internal capsule (increased Cho/Cr; p < 0.05), left thalamus (increased NAA/Cr; p = 0.011), anterior grey matter (increased NAA/Cr; p = 0.004), posterior grey matter (increased Cho/NAA; p = 0.016), anterior white matter (increased NAA/Cr; p = 0.012), and left posterior white matter (increased Cho/NAA; p = 0.022). The NPSLE patients showed significantly higher SLEDAI scores (p < 0.001).Conclusion: We found several significant distinct metabolic differences between NPSLE and non-NPSLE/HC patients in various brain locations.Keywords: systemic lupus erythematosus; SLE; neuropsychiatric systemic lupus erythematosus; NPSLE; spectroscopy

Download Full-text

White matter hyperintensities associate with cognitive slowing in patients with systemic lupus erythematosus and neuropsychiatric symptoms

RMD Open ◽

10.1136/rmdopen-2021-001650 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001650

Author(s):

Rory Caitlin Monahan ◽

Francesca Inglese ◽

Huub Middelkoop ◽

Mark van Buchem ◽

Tom WJ Huizinga ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cognitive Impairment ◽

Cognitive Function ◽

White Matter ◽

Lupus Erythematosus ◽

Neuropsychiatric Symptoms ◽

Pathophysiological Mechanism ◽

Systemic Lupus ◽

Total Group ◽

Matter Volume

ObjectiveTo compare cognitive function between patients with different phenotypes of neuropsychiatric systemic lupus erythematosus (NPSLE) and assess its association with brain and white matter hyperintensity (WMH) volumes.MethodsPatients attending the Leiden University Medical Centre NPSLE clinic between 2007 and 2015 without large brain infarcts were included (n=151; 42±13 years, 91% women). In a multidisciplinary consensus meeting, neuropsychiatric symptoms were attributed to systemic lupus erythematosus (SLE) (NPSLE, inflammatory (n=24) or ischaemic (n=12)) or to minor/non-NPSLE (n=115). Multiple regression analyses were performed to compare cognitive function between NPSLE phenotypes and to assess associations between brain and WMH volumes and cognitive function cross-sectionally.ResultsGlobal cognitive function was impaired in 5%, learning and memory (LM) in 46%, executive function and complex attention (EFCA) in 39% and psychomotor speed (PS) in 46% of all patients. Patients with inflammatory NPSLE showed the most cognitive impairment in all domains (p≤0.05).Higher WMH volume associated with lower PS in the total group (B: −0.14 (95% CI −0.32 to −0.02)); especially in inflammatory NPSLE (B: −0.36 (95% CI −0.60 to −0.12). In the total group, lower total brain volume and grey matter volume associated with lower cognitive functioning in all domains (all: 0.00/0.01 (0.00;0.01)) and lower white matter volume associated with lower LM, EFCA and PS (all: 0.00/0.01 (0.00;0.01)).ConclusionWe demonstrated that an association between brain and WMH volumes and cognitive function is present in patients with SLE, but differs between (NP)SLE phenotypes. WMHs associated with PS especially in inflammatory NPSLE, which suggests a different, potentially more severe underlying pathophysiological mechanism of cognitive impairment in this phenotype.

Download Full-text

Organized Intraglomerular Deposits in NZB Mouse Disease

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100066772 ◽

1971 ◽

Vol 29 ◽

pp. 544-545

Author(s):

Francis R. Comerford ◽

Alan S. Cohen

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Antinuclear Antibodies ◽

Human Systemic Lupus Erythematosus ◽

Systemic Lupus ◽

Glomerular Lesion ◽

Ultrastructural Studies ◽

Dense Deposits ◽

Experimental Nephritis ◽

Glomerular Lesions

Mice of the inbred NZB strain develop a spontaneous disease characterized by autoimmune hemolytic anemia, positive lupus erythematosus cell tests and antinuclear antibodies and nephritis. This disease is analogous to human systemic lupus erythematosus. In ultrastructural studies of the glomerular lesion in NZB mice, intraglomerular dense deposits in mesangial, subepithelial and subendothelial locations were described. In common with the findings in many examples of human and experimental nephritis, including many cases of human lupus nephritis, these deposits were amorphous or slightly granular in appearance with no definable substructure.We have recently observed structured deposits in the glomeruli of NZB mice. They were uncommon and were found in older animals with severe glomerular lesions by morphologic criteria. They were seen most commonly as extracellular elements in subendothelial and mesangial regions. The deposits ranged up to 3 microns in greatest dimension and were often adjacent to deposits of lipid-like round particles of 30 to 250 millimicrons in diameter and with amorphous dense deposits.

Download Full-text

“Subcortical” cognitive impairment in patients with systemic lupus erythematosus

Journal of the International Neuropsychological Society ◽

10.1017/s1355617700677093 ◽

2000 ◽

Vol 6 (7) ◽

pp. 821-825 ◽

Cited By ~ 29

Author(s):

ELIZABETH LERITZ ◽

JASON BRANDT ◽

MELISSA MINOR ◽

FRANCES REIS-JENSEN ◽

MICHELLE PETRI

Keyword(s):

Systemic Lupus Erythematosus ◽

Cognitive Impairment ◽

Lupus Erythematosus ◽

Systemic Lupus

Download Full-text