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Altered white matter microstructure in lupus patients : A diffusion tensor imaging study

Nystedt, Jessika LU ; Nilsson, Markus LU ; Jönsen, Andreas LU ; Nilsson, Petra LU ; Bengtsson, Anders LU ; Lilja, Åsa LU ; Lätt, Jimmy LU ; Mannfolk, Peter LU and Sundgren, Pia C. LU (2018) In Arthritis Research and Therapy 20(1).
Abstract

Background: The purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms. Methods: Structural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2-52.2 years) and 21 healthy controls (mean age 36.7 years, range 23.3-51.2 years) in conjunction with clinical examination, laboratory tests, cognitive evaluation, and self-assessment questionnaires. The patients were subgrouped according to the American College of Rheumatology Neuropsychiatric Systemic Lupus Erythematosus case definitions... (More)

Background: The purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms. Methods: Structural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2-52.2 years) and 21 healthy controls (mean age 36.7 years, range 23.3-51.2 years) in conjunction with clinical examination, laboratory tests, cognitive evaluation, and self-assessment questionnaires. The patients were subgrouped according to the American College of Rheumatology Neuropsychiatric Systemic Lupus Erythematosus case definitions into non-neuropsychiatric SLE (nonNPSLE) and neuropsychiatric SLE (NPSLE). Results: Comparisons between the SLE group and healthy controls showed that the mean fractional anisotropy (FA) was significantly reduced in the right rostral cingulum (p=0.038), the mid-sagittal corpus callosum (CC) (p=0.050), and the forceps minor of the CC (p=0.015). The mean diffusivity (MD) was significantly increased in the left hippocampal cingulum (p=0.017). No significant differences in MD or FA values were identified between NPSLE and nonNPSLE patients. Disease duration among all SLE patients correlated significantly with reduced FA in the CC (p<0.05). No correlations were found between DTI parameters and white matter hyperintensities, SLE Disease Activity Index-2000, Systemic Lupus International Collaborating Clinical/ACR Organ Damage Index, or Montgomery Asberg Depression Rate Score Self-report. Conclusions: We found alterations of white matter microstructure in SLE patients that were related to disease duration and fatigue. Our results indicate that cerebral involvement in SLE is not isolated to the NPSLE subgroup.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cognitive impairment, Diffusion tensor imaging, Magnetic resonance imaging, Neuropsychiatric systemic lupus erythematosus, Systemic lupus erythematosus, White matter microstructure
in
Arthritis Research and Therapy
volume
20
issue
1
pages
11 pages
publisher
BioMed Central
external identifiers
  • scopus:85041823196
ISSN
1478-6354
DOI
10.1186/s13075-018-1516-0
language
English
LU publication?
yes
id
6efd4501-623d-44ac-a624-99df9378d9c7
date added to LUP
2018-03-06 10:36:11
date last changed
2018-05-29 11:16:34
@article{6efd4501-623d-44ac-a624-99df9378d9c7,
  abstract     = {<p>Background: The purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms. Methods: Structural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2-52.2 years) and 21 healthy controls (mean age 36.7 years, range 23.3-51.2 years) in conjunction with clinical examination, laboratory tests, cognitive evaluation, and self-assessment questionnaires. The patients were subgrouped according to the American College of Rheumatology Neuropsychiatric Systemic Lupus Erythematosus case definitions into non-neuropsychiatric SLE (nonNPSLE) and neuropsychiatric SLE (NPSLE). Results: Comparisons between the SLE group and healthy controls showed that the mean fractional anisotropy (FA) was significantly reduced in the right rostral cingulum (p=0.038), the mid-sagittal corpus callosum (CC) (p=0.050), and the forceps minor of the CC (p=0.015). The mean diffusivity (MD) was significantly increased in the left hippocampal cingulum (p=0.017). No significant differences in MD or FA values were identified between NPSLE and nonNPSLE patients. Disease duration among all SLE patients correlated significantly with reduced FA in the CC (p&lt;0.05). No correlations were found between DTI parameters and white matter hyperintensities, SLE Disease Activity Index-2000, Systemic Lupus International Collaborating Clinical/ACR Organ Damage Index, or Montgomery Asberg Depression Rate Score Self-report. Conclusions: We found alterations of white matter microstructure in SLE patients that were related to disease duration and fatigue. Our results indicate that cerebral involvement in SLE is not isolated to the NPSLE subgroup.</p>},
  articleno    = {21},
  author       = {Nystedt, Jessika and Nilsson, Markus and Jönsen, Andreas and Nilsson, Petra and Bengtsson, Anders and Lilja, Åsa and Lätt, Jimmy and Mannfolk, Peter and Sundgren, Pia C.},
  issn         = {1478-6354},
  keyword      = {Cognitive impairment,Diffusion tensor imaging,Magnetic resonance imaging,Neuropsychiatric systemic lupus erythematosus,Systemic lupus erythematosus,White matter microstructure},
  language     = {eng},
  month        = {02},
  number       = {1},
  pages        = {11},
  publisher    = {BioMed Central},
  series       = {Arthritis Research and Therapy},
  title        = {Altered white matter microstructure in lupus patients : A diffusion tensor imaging study},
  url          = {http://dx.doi.org/10.1186/s13075-018-1516-0},
  volume       = {20},
  year         = {2018},
}