Cerebral and corpus callosum atrophy in systemic lupus erythematosus.
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.


CONCLUSIONS
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.
Appenzeller
Simone
S
University of Campinas, Sao Paulo, Brazil.
Rondina
Jane Maryam
JM
Li
Li Min
LM
Costallat
Lilian T L
LT
Cendes
Fernando
F
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D001284:Atrophy; D001927:Brain Diseases / Q000097:blood / Q000150:complications / Q000473:pathology*; D003337:Corpus Callosum / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D020945:Lupus Vasculitis, Central Nervous System / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D013997:Time Factors
D017152:Antibodies, Antiphospholipid; D005938:Glucocorticoids