title: Advanced MRI techniques: biomarkers in neuropsychiatric lupus.
abstract: Objectives The objective of this study was to determine whether advanced MRI could provide biomarkers for diagnosis and prognosis in neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Our prospective study included 28 systemic lupus erythematosus (SLE) patients with primary central NPSLE, 22 patients without NPSLE and 20 healthy controls. We used visual scales to evaluate atrophy and white matter hyperintensities, voxel-based morphometry and Freesurfer to measure brain volume, plus diffusion-tensor imaging (DTI) to assess white matter (WM) and gray matter (GM) damage. We compared the groups and correlated MRI abnormalities with clinical data. Results NPSLE patients had less GM and WM than controls ( p = 0.042) in the fronto-temporal regions and corpus callosum. They also had increased diffusivities in the temporal lobe WM ( p < 0.010) and reduced fractional anisotropy in the right frontal lobe WM ( p = 0.018). High clinical scores, longstanding disease, and low serum C3 were associated with atrophy, lower fractional anisotropy and higher diffusivity in the fronto-temporal lobes. Antimalarial treatment correlated negatively with atrophy in the frontal cortex and thalamus; it was also associated with lower diffusivity in the fronto-temporal WM clusters. Conclusions Atrophy and microstructural damage in fronto-temporal WM and GM in NPSLE correlate with severity, activity and the time from disease onset. Antimalarial treatment seems to give some brain-protective effects.
authors.affiliation: 1 Department of Neuroradiology, Hospital Clinic, Barcelona, Spain.|2 Department of Magnetic Resonance Imaging and Neuroradiology, Erasme University of Brussels (ULB), Brussels, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Sarbu
authors.affiliation: 3 Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Toledano
authors.affiliation: 4 Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Calvo
authors.affiliation: 5 Computer Vision and Robotics Group, University of Girona, Girona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Roura
authors.affiliation: 6 Department of Rheumatology, Centre Hospitaliere Universitaire (CHU) Saint-Pierre and Erasme Hospital, ULB, Brussels, Belgium.
authors.forename: M I
authors.initials: MI
authors.lastname: Sarbu
authors.affiliation: 3 Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Espinosa
authors.affiliation: 5 Computer Vision and Robotics Group, University of Girona, Girona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Lladó
authors.affiliation: 3 Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Cervera
authors.affiliation: 1 Department of Neuroradiology, Hospital Clinic, Barcelona, Spain.|4 Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi iSunyer (IDIBAPS), Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Bargalló
mesh_terms: D000328:Adult; D000368:Aged; D003337:Corpus Callosum / Q000000981:diagnostic imaging / Q000473:pathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D020945:Lupus Vasculitis, Central Nervous System / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult
keywords: Anti-malarial treatment; atrophy; brain; lupus; magnetic resonance imaging; malaria; neuropsychiatric systemic lupus erythematosus; systemic lupus erythematosus