title: Brain metabolism and autoantibody titres predict functional impairment in systemic lupus erythematosus.
abstract: OBJECTIVE
  We investigated whether systemic lupus erythematosus (SLE) disease duration or serology associate with abnormal regional glucose metabolism as measured with [(18)F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and deficits on neuropsychological testing.
  
  
  METHODS
  Subjects with SLE with stable disease activity, without brain damage or clinical symptoms of neuropsychiatric (NP) SLE, stratified by disease duration (short-term (ST)-SLE=disease ≤2 years, long-term (LT)-SLE=disease ≥10 years), underwent clinical assessments, neuropsychological testing, resting FDG-PET scan imaging and measurement of serum titres of antibody to N-methyl-d-aspartate receptor (DNRAb). FDG-PET scans were compared with age-matched and gender-matched healthy controls.
  
  
  RESULTS
  Subjects with LT-SLE demonstrated hypometabolism in the prefrontal and premotor cortices that correlated with accrued SLE-related damage, but not with DNRAb titre or performance on NP testing. Independent of disease duration, subjects with SLE demonstrated hypermetabolism in the hippocampus and orbitofrontal cortex that correlated with impaired memory performance and mood alterations (depression, anxiety, fatigue). Serum DNRAb also correlated independently with impaired memory performance and increased anxiety. Together, serum DNRAb titre and regional hypermetabolism were more powerful predictors of performance than either alone.
  
  
  CONCLUSIONS
  The presence of serum DNRAbs can account for some aspects of brain dysfunction in patients with SLE, and the addition of regional measurements of resting brain metabolism improves the assessment and precise attribution of central nervous system manifestations related to SLE.
authors: Center for Autoimmune and Musculoskeletal Disease, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Meggan
authors: M
authors: Mackay
authors: Center for Neurosciences, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Chris C
authors: CC
authors: Tang
authors: Center for Autoimmune and Musculoskeletal Disease, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Bruce T
authors: BT
authors: Volpe
authors: Center for Autoimmune and Musculoskeletal Disease, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Cynthia
authors: C
authors: Aranow
authors: Center for Neurosciences, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Paul J
authors: PJ
authors: Mattis
authors: Center for Autoimmune and Musculoskeletal Disease, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Ricki A
authors: RA
authors: Korff
authors: Center for Autoimmune and Musculoskeletal Disease, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: Betty
authors: B
authors: Diamond
authors: Center for Neurosciences, The Feinstein Institute for Medical Research , Manhasset, New York , USA.
authors: David
authors: D
authors: Eidelberg
keywords: Autoantibodies; Autoimmune Diseases; Systemic Lupus Erythematosus