Clinical Factors Associated with Brain Volume Reduction in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations.
Clinical Factors Associated with Brain Volume Reduction in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations.
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与无主要神经精神表现的系统性红斑狼疮患者脑容量减少相关的临床因素
DOI：
10.3389/fpsyt.2018.00008
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发表时间：
2018
影响因子：
4.7
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Liu S;Cheng Y;Zhao Y;Yu H;Lai A;Lv Z;Xu X;Luo C;Shan B;Xu L;Xu J
该研究的目的是使用定量磁共振成像（MRI）发现无主要神经精神症状的系统性红斑狼疮患者[非神经精神性系统性红斑狼疮（non-NPSLE）]的脑结构变化及其与临床特征的可能相关性。89例常规MRI正常的非NPSLE患者和84例健康对照（HC）。计算每个个体的全脑灰质体积（GMV）和白色物质体积（WMV）。我们发现系统性红斑狼疮（SLE）组的GMV和WMV较HCs组明显降低。女性患者GMV和WMV较男性患者明显降低。用免疫抑制剂（伊萨）治疗的患者WMV降低程度低于未用免疫抑制剂的患者。认知功能障碍是最常见的亚临床神经精神症状，患病率为46.1%。发现WMV降低与认知功能障碍相关，因此，我们得出结论，结构性脑萎缩甚至可以在明显的神经精神症状和体征出现之前发生，并与认知功能障碍等亚临床症状相关。伊萨治疗对脑萎缩有保护作用。早期治疗可能会防止对大脑的渐进性损害。需要更多的研究来充分了解SLE脑萎缩的复杂的潜在机制。
The aim of the study was to find structural brain changes in systemic lupus erythematosus patients without major neuropsychiatric manifestations [non-neuropsychiatric systemic lupus erythematosus (non-NPSLE)] using quantitative magnetic resonance imaging (MRI) and possible associations with clinical characteristics. 89 non-NPSLE patients with normal conventional MRI and 84 healthy controls (HCs) were recruited. The whole brain gray matter volume (GMV) and white matter volume (WMV) were calculated for each individual. We found obvious GMV and WMV reduction in the systemic lupus erythematosus (SLE) group compared with HCs. Female patients showed significant reduction of GMV and WMV compared with male patients. Patients treated with immunosuppressive agents (ISA) showed less WMV reduction than those without. Cognitive impairment was the most common subclinical neuropsychiatric manifestation and had a prevalence of 46.1%. Association between WMV reduction with cognitive impairment was found. Thus, we concluded that structural brain atrophy could happen even before occurrence of obvious neuropsychiatric signs and symptoms and was associated with subclinical symptoms such as cognitive impairment. ISA treatment might have a protective effect on the brain atrophy. Early treatment might prevent the progressive damage to the brain. More studies are needed to fully understand the complicated underlying mechanisms of brain atrophy in SLE.
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影响因子：
2.6
作者：
Abbott, NJ;Mendonça, LLF;Dolman, DEM
通讯作者：
Dolman, DEM
影响因子：
13.3
作者：
Lapa, Aline Tamires;Postal, Mariana;Appenzeller, Simone
通讯作者：
Appenzeller, Simone
影响因子：
7.5
作者：
Banasr, Mounira;Dwyer, Jason M.;Duman, Ronald S.
通讯作者：
Duman, Ronald S.
影响因子：
6.6
作者：
Cole, James;Costafreda, Sergi G.;Fu, Cynthia H. Y.
通讯作者：
Fu, Cynthia H. Y.
影响因子：
6.9
作者：
Elbejjani, M.;Fuhrer, R.;Dufouil, C.
通讯作者：
Dufouil, C.