Central nervous system involvement in Sjögren's syndrome: evidence from neuropsychological testing and HMPAO-SPECT.
OBJECTIVE
To investigate the clinical, neuropsychological and imaging manifestations of Sjögren's syndrome (SS), a chronic auto-immune disease with peripheral and central nervous system (CNS) involvement.


METHODS
Fourteen female patients suffering from confirmed SS underwent within 2 weeks: neurological examination, immunological staging, brain MRI, brain 99m Tc-HMPAO SPECT, psychological evaluation and in-depth neuropsychological testing.


RESULTS
All patients showed neuropsychological abnormalities. The cognitive symptoms were of the same type in all patients, mostly frontal lobe syndrome and memory problems. The neuropsychological involvement was not associated with other kinds of CNS involvement or MRI abnormalities, but accurately reflected HMPAO imaging results.


CONCLUSIONS
The results of this study indicate that cognitive evaluation is the most sensitive clinical test to diagnose CNS involvement in patients with SS, and that CNS involvement in SS seems to be more frequent when systematically assessed by neuropsychological tests.
Belin
C
C
Service de Neurologie, CHU Avicenne, Université Paris-XIII, Bobigny, France. catherine.belin@avc.ap-hop-paris.fr
Moroni
C
C
Caillat-Vigneron
N
N
Debray
M
M
Baudin
M
M
Dumas
J L
JL
Moretti
J L
JL
Delaporte
P
P
Guillevin
L
L
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003071:Cognition; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008279:Magnetic Resonance Imaging; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011581:Psychological Tests; D012859:Sjogren's Syndrome / Q000150:complications*; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D019690:Technetium Tc 99m Exametazime