title: Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus.
abstract: OBJECTIVE
  To investigate the relationship between quantitative estimates of global brain damage based on magnetization transfer imaging (MTI) and cerebral functioning, as measured by neurologic, psychiatric, and cognitive assessments, as well as disease duration in patients with a history of neuropsychiatric systemic lupus erythematosus (NPSLE).
  
  
  METHODS
  In a clinically heterogeneous group of 24 female patients (age range 19-65 years, mean age 35 years) with a history of NPSLE, the correlation values of several volumetric MTI measures and an estimate of cerebral atrophy, neurologic functioning (Kurtzke's Expanded Disability Status Scale [EDSS]), psychiatric functioning (the Hospital Anxiety and Depression Scale [HADS]), and cognitive functioning (cognitive impairment score [CIS] derived from the revised Wechsler Adult Intelligence Scale), as well as several measures of disease duration were assessed using Pearson's correlation coefficient.
  
  
  RESULTS
  Quantitative volumetric estimates of global brain damage based on MTI and a measure of global brain atrophy correlated significantly with the EDSS, HADS, and CIS scores. No significant correlation was found between the quantitative estimates of global brain damage and the measures of disease duration.
  
  
  CONCLUSIONS
  The results of this study demonstrate that volumetric MTI parameters and cerebral atrophy reflect functionally relevant brain damage in patients with NPSLE. Furthermore, the absence of a linear relationship between disease duration and results of volumetric MTI measures and atrophy suggests a complicated pattern of accumulating brain damage in patients with NPSLE.
authors.affiliation: Department of Radiology C2S, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. G.P.T.Bosma@lumc.nl
authors.forename: G P Th
authors.initials: GP
authors.lastname: Bosma
authors.forename: H A M
authors.initials: HA
authors.lastname: Middelkoop
authors.forename: M J
authors.initials: MJ
authors.lastname: Rood
authors.forename: E L E M
authors.initials: EL
authors.lastname: Bollen
authors.forename: T W J
authors.initials: TW
authors.lastname: Huizinga
authors.forename: M A
authors.initials: MA
authors.lastname: van Buchem
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000473:pathology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged