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

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

Early Diagnosis of Neuropsychiatric Systemic Lupus Erythematosus by Deep Learning Enhanced Magnetic Resonance Spectroscopy

2021 ◽  
Vol 11 (5) ◽  
pp. 1341-1347
Author(s):  
Xin Li ◽  
Lu Bai ◽  
Zuhao Ge ◽  
Zhizhe Lin ◽  
Xi Yang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Magnetic Resonance Spectroscopy ◽  
Lupus Erythematosus ◽  
Support Vector ◽  
Resonance Spectroscopy ◽  
Systemic Lupus ◽  
Proton Mrs ◽  
Neuropsychiatric Systemic Lupus Erythematosus

The neuropsychiatric systemic lupus erythematosus (NPSLE) has higher disability and mortality rates, which is one of the main causes of death in systemic lupus erythematosus (SLE) patients. Magnetic resonance spectroscopy (MRS) can detect the changes of metabolites in different intracranial areas in vivo in patients with SLE, so as to provide evidence for the early diagnosis of NPSLE. Different from the conventional single-voxel MRS, which can only screen one brain region with one metabolic change, we simultaneously detect 13 kinds of intracranial metabolic changes in nine brain regions by multivoxel proton MRS (MVS). We use a recursive feature elimination algorithm to select the most related metabolites for better identifying NPSLE. To accurately diagnosis NPSLE by these intracranial metabolites, we train a support vector machine deep stacked network (SVM-DSN) for quantitative analysis of these metabolites. Comparing with the conventional statistic method, which is about 70% of accuracy, the proposed model achieves 97.5% of accuracy for NPSLE diagnosis. We conclude the trained SVM-DSN can effectively analyze the metabolites obtained by multivoxel proton MRS for NPSLE diagnosis, which may help to early diagnosis and intervention of NPSLE, and alleviate the bias of manual screening.

scholarly journals A critical analysis of the tools to evaluate neuropsychiatric lupus

Lupus ◽  
2017 ◽  
Vol 26 (5) ◽  
pp. 504-509 ◽  
Author(s):  
K E N Clark ◽  
C N Clark ◽  
A Rahman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Magnetic Resonance ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Testing ◽  
Resonance Imaging ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus ◽  
Neuropsychiatric Manifestations

Neuropsychiatric symptoms occur commonly in patients with systemic lupus erythematosus, but they are not always due to active disease. It is crucial to identify cases that are due to active systemic lupus erythematosus so that appropriate treatment can be instituted. There is no single serological or imaging test that distinguishes active neuropsychiatric systemic lupus erythematosus from neuropsychiatric manifestations caused by other factors such as infection. Most patients with neuropsychiatric systemic lupus erythematosus have generalised features of disease activity. Raised anti-dsDNA and low C3 complement levels are often seen, but are not an invariable guide. The presence of antiphospholipid antibodies is more suggestive of thrombotic than inflammatory causation. A number of other autoantibody tests have been proposed as biomarkers for neuropsychiatric systemic lupus erythematosus, but results in clinical studies have been inconsistent and none has so far entered routine clinical practice. Cerebrospinal fluid features and magnetic resonance imaging appearances are non-specific in neuropsychiatric systemic lupus erythematosus, but are useful in excluding other causes of neuropsychiatric symptoms. Newer magnetic resonance imaging sequences show promise for distinguishing new neuropsychiatric systemic lupus erythematosus activity from previous damage and recent research suggests these may correlate with changes in cognitive function in patients with systemic lupus erythematosus. However, formal cognitive testing is seldom carried out in the acute setting.

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