Open AccessCerebral and corpus callosum atrophy in systemic lupus erythematosus
Author(s) -
Appenzeller Simone,
Rondina Jane Maryam,
Li Li Min,
Costallat Lilian T. L.,
Cendes Fernando
Publication year - 2005
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.21271
Subject(s) - corpus callosum , medicine , atrophy , cerebral atrophy , magnetic resonance imaging , lupus erythematosus , pathology , cardiology , radiology , antibody , immunology
Objective To determine cerebral and corpus callosum volumes in patients with systemic lupus erythematosus (SLE), using semiautomatic magnetic resonance imaging (MRI) volumetric measurements, and to determine possible relationships between a reduction in cerebral volume and disease duration, total corticosteroid dose, neuropsychiatric manifestations, and the presence of antiphospholipid antibodies. Methods We studied 115 consecutive patients with SLE and 44 healthy volunteers. A complete clinical, laboratory, and neurologic evaluation was performed. MRI scans were obtained through a standardized protocol. Sagittal T1‐weighted images were used for semiautomatic volumetric measurements. We compared SLE patients with controls using the 2‐sample t ‐test. Analysis of variance was used to test for differences between groups, followed by Tukey's post hoc test for pairwise comparisons, when necessary. Linear regression was used to analyze the association between cerebral atrophy and disease duration and total corticosteroid dose. Results Cerebral and corpus callosum volumes were significantly smaller in patients with SLE compared with healthy volunteers ( P < 0.001). Reduced cerebral and corpus callosum volumes were related to disease duration ( P < 0.001). Patients with a history of central nervous system (CNS) involvement more frequently had a reduction in cerebral and corpus callosum volumes ( P < 0.001). Patients with cognitive impairment had significantly reduced corpus callosum and cerebral volumes when compared with SLE patients without cognitive impairment ( P = 0.001). Cerebral and corpus callosum volumes were not associated with the total corticosteroid dose or the presence of antiphospholipid antibodies. Conclusion In patients with SLE, a reduction in cerebral and corpus callosum volumes is associated with disease duration, a history of CNS involvement, and cognitive impairment. The total corticosteroid dose and the presence of antiphospholipid antibodies were not associated with more pronounced atrophy.