title: Microembolic signals in patients with systemic lupus erythematosus.
abstract: BACKGROUND
  Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.
  
  
  METHODS
  Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.
  
  
  RESULTS
  MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).
  
  
  CONCLUSIONS
  MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.
authors.affiliation: Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Azarpazhooh
authors.forename: Naghmeh
authors.initials: N
authors.lastname: Mokhber
authors.forename: Elias
authors.initials: E
authors.lastname: Orouji
authors.forename: Brian R
authors.initials: BR
authors.lastname: Chambers
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Hatef
authors.forename: Zahra
authors.initials: Z
authors.lastname: Rezaieyazdi
authors.forename: Sima
authors.initials: S
authors.lastname: Sedighi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Foroghipoor
authors.forename: Arash
authors.initials: A
authors.lastname: Velayati
authors.forename: Morteza Modares
authors.initials: MM
authors.lastname: Gharavi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods; D055815:Young Adult