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Neuropsychiatric systemic lupus erythematosus is associated with a distinct type and shape of cerebral white matter hyperintensities

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posted on 2023-06-10, 03:51 authored by Francesca Inglese, Myriam G Jaarsma-Coes, Gerda M Steup-Beekman, Rory Monahan, Tom Huizinga, Mark A van Buchem, Itamar RonenItamar Ronen, Jeroen de Bresser
OBJECTIVES: Advanced white matter hyperintensity (WMH) markers on brain MRI may help reveal underlying mechanisms and aid in the diagnosis of different phenotypes of SLE patients experiencing neuropsychiatric (NP) manifestations. METHODS: In this prospective cohort study, we included a clinically well-defined cohort of 155 patients consisting of 38 patients with NPSLE (26 inflammatory and 12 ischaemic phenotype) and 117 non-NPSLE patients. Differences in 3?T MRI WMH markers (volume, type and shape) were compared between patients with NPSLE and non-NPSLE and between patients with inflammatory and ischaemic NPSLE by linear and logistic regression analyses corrected for age, sex and intracranial volume. RESULTS: Compared with non-NPSLE [92% female; mean age 42 (13)?years], patients with NPSLE [87% female; mean age 40 (14)?years] showed a higher total WMH volume [B (95%-CI)]: 0.46 (0.0 7 ? 0.86); P?=?0.021], a higher periventricular/confluent WMH volume [0.46 (0.0 6 ? 0.86); P?=?0.024], a higher occurrence of periventricular with deep WMH type [0.32 (0.1 3 ? 0.77); P?=?0.011], a higher number of deep WMH lesions [3.06 (1.2 1 ? 4.90); P?=?0.001] and a more complex WMH shape [convexity: ?0.07 (?0.12 ? ?0.02); P?=?0.011, concavity index: 0.05 (0.0 1 ? 0.08); P?=?0.007]. WMH shape was more complex in inflammatory NPSLE patients [89% female; mean age 39 (15)?years] compared with patients with the ischaemic phenotype [83% female; mean age 41 (11)?years] [concavity index: 0.08 (0.0 1 ? 0.15); P?=?0.034]. CONCLUSION: We demonstrated that patients with NPSLE showed a higher periventricular/confluent WMH volume and more complex shape of WMH compared with non-NPSLE patients. This finding was particularly significant in inflammatory NPLSE patients, suggesting different or more severe underlying pathophysiological abnormalities.

History

Publication status

  • Published

File Version

  • Published version

Journal

Rheumatology

ISSN

1462-0324

Publisher

Oxford University Press (OUP)

Issue

6

Volume

61

Page range

2663-2671

Event location

England

Department affiliated with

  • BSMS Neuroscience Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2022-06-14

First Open Access (FOA) Date

2022-06-14

First Compliant Deposit (FCD) Date

2022-06-13

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