Cognitive function and 99mTc-ECD brain SPECT are significantly correlated in patients with primary Sjogren syndrome: a case-control study.
OBJECTIVE
To assess subclinical central nervous system (CNS) involvement in primary Sjögren syndrome (pSS), by comparing standard brain MRI, in-depth neuropsychological testing and (99m)Tc-ECD brain single-photon emission computed tomography (SPECT) of patients with pSS with matched controls.


METHODS
10 women (<55 years old), with pSS defined using European-American criteria, presence of anti-SSA and/or anti-SSB antibodies and no history of neurological involvement were prospectively investigated, and compared with 10 age- and sex-matched controls. All subjects underwent, within 1 month, brain MRI, neuropsychological testing, including overall evaluation and focal cognitive function assessment, and (99m)Tc-ECD brain SPECT.


RESULTS
(99m)Tc-ECD brain SPECT abnormalities were significantly more common in patients with pSS (10/10) than controls (2/10; p<0.05). Cognitive dysfunctions, mainly expressed as executive and visuospatial disorders, were also significantly more common in patients with pSS (8/10) than controls (0/10; p<0.01). Notably, between-group comparisons enabled a significant correlation to be established between neuropsychological assessment and (99m)Tc-ECD brain SPECT abnormalities in patients with pSS (r(s) = 0.49, p<0.01). MRI abnormalities in patients and controls did not differ significantly.


CONCLUSIONS
Neuropsychological testing and (99m)Tc-ECD brain SPECT seem to be the most sensitive tools to detect subclinical CNS dysfunction in pSS. The strong correlation between cortical hypoperfusion in (99m)Tc-ECD brain SPECT and cognitive dysfunction suggests an organic aetiology of CNS dysfunction in pSS. These data should be confirmed in a larger study.
Le Guern
V
V
Department of Internal Medicine, Hôpital Cochin, 27, rue du faubourg Saint-Jacques, 75679 Paris Cedex 14, France. veronique.le-guern@cch.aphp.fr
Belin
C
C
Henegar
C
C
Moroni
C
C
Maillet
D
D
Lacau
C
C
Dumas
J L
JL
Vigneron
N
N
Guillevin
L
L
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009483:Neuropsychological Tests; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012859:Sjogren's Syndrome / Q000000981:diagnostic imaging / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine