White matter lesions and brain atrophy in systemic lupus erythematosus patients: correlation to cognitive dysfunction in a cohort of systemic lupus erythematosus patients using different definition models for neuropsychiatric systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1140-1149 ◽  
Author(s):  
B Cannerfelt ◽  
J Nystedt ◽  
A Jönsen ◽  
J Lätt ◽  
D van Westen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Corpus Callosum ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Verbal Memory ◽  
White Matter Lesions ◽  
Cognitive Test ◽  
Systemic Lupus ◽  
Neuropsychiatric Sle

Aim The aim of this study was to evaluate the extent of white matter lesions, atrophy of the hippocampus and corpus callosum, and their correlation with cognitive dysfunction (CD), in patients diagnosed with systemic lupus erythematosus (SLE). Methods Seventy SLE patients and 25 healthy individuals (HIs) were included in the study. To evaluate the different SLE and neuropsychiatric SLE (NPSLE) definition schemes, patients were grouped both according to the American College of Rheumatology (ACR) definition, as well as the more stringent ACR-Systemic Lupus International Collaborating Clinics definition. Patients and HIs underwent a 3 Tesla brain MRI and a standardized neuropsychological test. MRI data were evaluated for number and volume of white matter lesions and atrophy of the hippocampus and corpus callosum. Differences between groups and subgroups were evaluated for significance. Number and volume of white matter lesions and atrophy of the hippocampus and corpus callosum were correlated to cognitive dysfunction. Results The total volume of white matter lesions was significantly larger in SLE patients compared to HIs ( p = 0.004). However, no significant differences were seen between the different SLE subgroups. Atrophy of the bilateral hippocampus was significantly more pronounced in patients with NPSLE compared to those with non-NPSLE (right: p = 0.010; left p = 0.023). Significant negative correlations between cognitive test scores on verbal memory and number and volume of white matter lesions were present. Conclusion SLE patients have a significantly larger volume of white matter lesions on MRI compared to HIs and the degree of white matter lesion volume correlates to cognitive dysfunction, specifically to verbal memory. No significant differences in the number or volume of white matter lesions were identified between subgroups of SLE patients regardless of the definition model used.

scholarly journals Internal Carotid Artery Occlusion in Systemic Lupus Erythematosus as a Potential Mimicker of Multiple Sclerosis

2017 ◽  
Vol 9 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Kenichiro Sato ◽  
Mami Kanzaki ◽  
Yoshifumi Ubara ◽  
Yoshikazu Uesaka
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Lupus Erythematosus ◽  
Internal Carotid ◽  
White Matter Lesions ◽  
Systemic Lupus ◽  
Neuropsychiatric Sle

The diagnosis of neurological symptoms in patients with systemic lupus erythematosus (SLE) is often challenging, in part because they sometimes mimic features of multiple sclerosis (MS). Herein we report a case of a young female who presented with relapsing-remitting symptoms of unilateral visual loss and motor aphasia. Additionally, radiological findings revealed multiple white matter lesions on her brain that led to an initial diagnosis of MS based on the established diagnostic criteria. However, she was eventually diagnosed with neuropsychiatric SLE (NPSLE) presenting with extracranial internal carotid artery (ICA) occlusion. Her ICA occlusion had not been detected for 2 months until she underwent magnetic resonance angiography. Although exact underlying pathological mechanisms are unclear, both the ICA occlusion and MS-like brain white matter lesions could be attributed to SLE. This case demonstrated that both of these lesions can coexist in the same patient, suggesting that NPSLE with ICA occlusion can be a potential mimicker of MS, and vice versa. Care must be paid to avoid delay in the diagnosis.

The relationship of antiphospholipid antibodies to cognitive function in patients with systemic lupus erythematosus

1997 ◽  
Vol 3 (4) ◽  
pp. 377-386 ◽  
Author(s):  
SUSAN D. DENBURG ◽  
RAMONA M. CARBOTTE ◽  
JEFFREY S. GINSBERG ◽  
JUDAH A. DENBURG
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Verbal Memory ◽  
Lupus Anticoagulant ◽  
Cognitive Test ◽  
Antiphospholipid Antibody ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Antibody Positivity ◽  
The Relationship

Objective: To examine the relationship between antiphospholipid antibody positivity (expressed as the lupus anticoagulant) and cognitive dysfunction in patients with systemic lupus erythematosus (SLE). Methods: Cross-sectional comparisons of lupus anticoagulant (LA) positive (N = 39) and negative (N = 79) patients and controls (N = 35) on a cognitive test battery; 22 LA-positive and 53 LA-negative patients who had never experienced neuropsychiatric events (never-NP–SLE) were also compared separately. Results: LA-positive patients were 2 to 3 times more likely than were LA-negative patients to be designated as cognitively impaired. As a group, LA-positive patients, particularly those in the never-NP–SLE group, demonstrated lower performance primarily on tasks of verbal memory, cognitive flexibility, and psychomotor speed. Conclusions: LA positivity is associated with subclinical nervous system compromise, and a pattern of deficits compatible with subcortical involvement, possibly on the basis of ongoing LA-related microthrombotic events or vasculopathy. (JINS, 1997, 3, 377–386.)

Distribution of White Matter Lesions in Multiple Sclerosis and Systemic Lupus Erythematosus

1998 ◽  
Vol 11 (2_suppl) ◽  
pp. 17-19
Author(s):  
M.T. Peltz ◽  
L. Casciu ◽  
F.M. Manconi ◽  
G. Sanna ◽  
P. Schiffini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
White Matter Lesions ◽  
Systemic Lupus

scholarly journals Association of lipoproteins and thyroid hormones with cognitive dysfunction in patients with systemic lupus erythematosus

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Li Lu ◽  
Wei Kong ◽  
Kangxing Zhou ◽  
Jinglei Chen ◽  
Yayi Hou ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Line Orientation ◽  
Systemic Lupus ◽  
Clinical Biomarkers ◽  
Orientation Scores ◽  
Neuropsychiatric Sle ◽  
Dsdna Antibody

Abstract Background Neuropsychiatric manifestations occur in up to 75% of adult systemic lupus erythematosus (SLE) patients and are one of the major causes of death in SLE patients. Cognitive dysfunction is a typical clinical feature of neuropsychiatric SLE (NPSLE), which seriously affects the quality of life of patients. Dyslipidaemia and thyroid symptoms, which are prevalent in SLE patients, have both been related to neuropsychiatric disturbances, including significant psychiatric and cognitive disturbances. This study aimed to investigate whether cognitive dysfunction in patients with SLE was related to the expression of serum thyroid hormone and lipoprotein levels. Methods A total of 121 patients with SLE and 65 healthy controls (HCs) at Nanjing Drum Tower Hospital completed a cognitive function test, and 81 SLE patients were divided into a high-cognition (n = 33) group and a low-cognition group (n = 48). The clinical and laboratory characteristics of the patients were compared; moreover, correlations between serum HDL-C, LDL-C, F-T3 and F-T4 levels and cognitive function were analysed. Serum levels of APOE, APOA1, IGF-1, and IGFBP7 in 81 patients were detected by ELISA, and the correlation between these four proteins and cognition was analysed separately. Results The patients with SLE with abnormal cognitive function were less educated than the HCs. For low-cognition patients, the levels of albumin, F-T3 (P <  0.05) and F-T4 decreased, while D-dimer, anti-dsDNA antibody, and IgM levels increased. Serum F-T3 and F-T4 levels positively correlated with cognition. Furthermore, serum protein levels of APOE and APOA1 showed no difference between the high- and low-cognition groups. However, the serum APOE levels were negatively correlated with line orientation scores, and APOA1 levels were positively correlated with coding scores. Conclusions Serum F-T3 and F-T4 levels were both positively correlated with four indexes of cognition (language was the exception), while serum APOE levels were negatively correlated with line orientation scores, APOA1 levels were positively correlated with coding scores, and IGFBP7 levels were negatively correlated with figure copy scores. These results demonstrated that F-T3 and F-T4 might be clinical biomarkers of cognitive dysfunction in SLE.

Cognitive Dysfunction and White Matter Abnormalities in Systemic Lupus Erythematosus

2011 ◽  
Vol 17 (3) ◽  
pp. 385-392 ◽  
Author(s):  
Elizabeth Kozora ◽  
Christopher M. Filley
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Cognitive Dysfunction ◽  
Processing Speed ◽  
Lupus Erythematosus ◽  
Neuronal Damage ◽  
Cerebral Atrophy ◽  
Periventricular White Matter ◽  
Systemic Lupus ◽  
Neuroimaging Techniques

AbstractBrain abnormalities have been documented by neuropsychological assessment as well as a variety of neuroimaging techniques in patients with systemic lupus erythematosus (SLE). Conventional neuroimaging in patients with neuropsychiatric disease (NPSLE) typically discloses periventricular white matter (WM) hyperintensities, infarcts, hemorrhages, and cerebral atrophy. In SLE patients with none of these findings, sophisticated neuroimaging techniques have recently supported associations between microstructural WM abnormalities and abnormal attention, executive function, and processing speed. This mild cognitive dysfunction in SLE (MCD-SLE), which may result from early myelinopathy, precedes the more severe cognitive dysfunction of NPSLE, related to more obvious WM and neuronal damage. (JINS, 2011, 17, 385–392)

scholarly journals MRI-based classification of neuropsychiatric systemic lupus erythematosus patients with self-supervised contrastive learning

2021 ◽  
Author(s):  
Francesca Inglese ◽  
Minseon Kim ◽  
Gerda M. Steup-Beekman ◽  
Tom W.J. Huizinga ◽  
Mark van Buchem ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Lupus Erythematosus ◽  
Common Finding ◽  
Periventricular White Matter ◽  
Training Procedure ◽  
Systemic Lupus ◽  
Common Features ◽  
Neuropsychiatric Sle ◽  
The Common

AbstractIntroduction/PurposeSystemic lupus erythematosus (SLE) is a chronic auto-immune disease with a broad spectrum of clinical presentations, including heterogeneous and uncommon neuropsychiatric (NP) syndromes. Accurate diagnosis of neuropsychiatric SLE (NPSLE) is challenging due to lack of clinically useful biomarkers. Despite structural brain abnormalities on MRI in NPSLE being a common finding, a robust link between structural abnormalities and NPSLE has not been established, thus their contribution to the distinction between NPSLE patients and patients in which the NP symptoms are not primarily attributed to SLE is limited. Self-supervised contrastive learning algorithms do not require labels, and have been shown to be useful in classification tasks in rare diseases with limited number of datasets. The aim of our study was to apply self-supervised contrastive learning on T1-weighted images acquired from a well-defined cohort of SLE patients to distinguish between SLE patients with NP symptoms due to the disease (NPSLE) or and SLE patients with similar symptoms due to other causes (non-NPSLE).Subjects and Methods163 patients were included. We used 3T MRI T1-weighted images registered to the MNI152 template. The training set comprised 68 non-NPSLE and 34 NPSLE patients. During the training procedure, we applied random geometric transformations (cropping, left-right flipping and rotations) between iterations to enrich our data sets. Our ML pipeline consisted of convolutional base encoder and linear projector. To test the classification task, the projector was removed and one linear layer was measured. We trained the encoder and projector with the Normalized Temperature-scaled Cross Entropy Loss (NT-xent) loss function. We performed a Monte Carlo validation that consisted of 6 repeated random sub-samplings each using a random selection of a small group of samples from each group.ResultsIn the 6 trials described above, between 79% and 83% of the patients were correctly classified as NPSLE or non-NPSLE. For a qualitative evaluation of spatial distribution of the common features found in the NPSLE population, Gradient-weighted Class Activation Maps (Grad-CAM) were examined voxel-wise. Thresholded Grad-CAM maps show areas of common features identified for the NPSLE cohort, with no such communality found for the non-NPSLE group.Discussion/conclusionThe self-supervised contrastive learning model was effective in capturing diagnostic brain MRI features from a limited but well-defined cohort of SLE patients with NP symptoms. The interpretation of the Grad-CAM results is not straightforward, but points to involvement of the lateral and third ventricles, periventricular white matter and basal cisterns. We believe that the common features found in the NPSLE population in this study indicate a combination of tissue loss, local atrophy and to some extent that of periventricular white matter lesions, which are commonly found in NPSLE patients and appear hypointense on T1-weighted images.

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