Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Cesar, B.; Dwyer, Michael G.; Shucard, Janet L.; Polak, Paul; Bergsland, Niels; Benedict, Ralph H. B.; Weinstock‐Guttman, B.; Shucard, David W.; Zivadinov, Robert

doi:10.3174/ajnr.a4354

Cited by 30 publications

(22 citation statements)

References 53 publications

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“…DTI studies have suggested WM damage in well-defined NP SLE patients, particularly in areas of the frontal lobe, frontobasal and temporal WM tracts, and the corpus callosum (CC). [16][17][18][19][20] Studies in SLE patients without NP activity have also demonstrated DTI abnormalities. Compared to controls, lower FA was found in SLE patients without NP in the right cingulum, 21 normal appearing WM, 22 right superior coronal radiata, the right superior longitudinal fasciculus, the body of the CC, the right inferior fronto-occiptal fasciculus, the right thalamic radiation, the right uncinate fasciculus, 23 and in the CC genu and left corticospinal tract.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal evaluation of diffusion tensor imaging and cognition in systemic lupus erythematosus

Kozora

Filley

Erkan

et al. 2018

Lupus

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Objective This pilot study aimed to examine longitudinal changes in brain structure and function in patients with systemic lupus erythematosus (SLE) using diffusion tensor imaging (DTI) and neuropsychological testing. Methods Fifteen female SLE patients with no history of major neuropsychiatric (NP) manifestations had brain magnetic resonance imaging (MRI) with DTI at baseline and approximately 1.5 years later. At the same time points, a standardized battery of cognitive tests yielding a global cognitive impairment index (CII) was administered. At baseline, the SLE patients had mean age of 34.0 years (SD = 11.4), mean education of 14.9 years (SD = 2.1), and mean disease duration of 121.5 months (SD = 106.5). The MRI images were acquired with a 3T GE MRI scanner. A DTI sequence with 33 diffusion directions and b-value of 800 s/mm was used. Image acquisition time was about 10 minutes. Results No significant change in cognitive dysfunction (from the CII) was detected. Clinically evaluated MRI scans remained essentially unchanged, with 62% considered normal at both times, and the remainder showing white matter (WM) hyperintensities that remained stable or resolved. DTI showed decreased fractional anisotropy (FA) and increased mean diffusivity (MD) in bilateral cerebral WM and gray matter (GM) with no major change in NP status, medical symptoms, or medications over time. Lower FA was found in the following regions: left and right cerebral WM, and in GM areas including the parahippocampal gyrus, thalamus, precentral gyrus, postcentral gyrus, angular gyrus, parietal lobe, and cerebellum. Greater MD was found in the following regions: left and right cerebral WM, frontal cortex, left cerebral cortex, and the putamen. Conclusions This is the first longitudinal study of DTI and cognition in SLE, and results disclosed changes in both WM and GM without cognitive decline over an 18-month period. DTI abnormalities in our participants were not associated with emergent NP activity, medical decline, or medication changes, and the microstructural changes developed in the absence of macrostructural abnormalities on standard MRI. Microstructural changes may relate to ongoing inflammation, and the stability of cognitive function may be explained by medical treatment, the variability of NP progression in SLE, or the impact of cognitive reserve.

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Section: Introductionmentioning

confidence: 99%

Longitudinal evaluation of diffusion tensor imaging and cognition in systemic lupus erythematosus

Kozora

Filley

Erkan

et al. 2018

Lupus

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“…It has been suggested that SLE patients mainly experience difficulties in attention, information processing, learning, memory, and executive functions (Ainiala, Loukkola, Peltola, Korpela, & Hietaharju, 2001; Kozora et al, 2005;Kozora, Arciniegas, et al, 2008) and that SLE-patients, similar to patients suffering from multiple sclerosis, tend to show relatively well-preserved verbal functions (Cesar et al, 2015;Hanly, Omisade, Su, Farewell, & Fisk, 2010;Papathanasiou, Messinis, Georgiou, & Papathanasopoulos, 2014).…”

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Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

Nystedt

Mannfolk

Jönsen

et al. 2019

J of Comparative Neurology

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To investigate core resting state networks in SLE patients with and without neuropsychiatric symptoms by examining functional connectivity changes correlating with results of cognitive testing. Structural MRI and resting state‐fMRI (rs‐fMRI) were performed in 61 female SLE patients (mean age: 36.8 years, range 18.2–52.0 years) and 20 healthy controls (HC) (mean age 36.2 years, range 23.3–52.2 years) in conjunction with clinical examination and cognitive testing. Alterations in core resting state networks, not found in our healthy controls sample, correlated with cognitive performance gauged by neuropsychological tests in non‐neuropsychiatric SLE (nNP) as well as in neuropsychiatric SLE patients (NP). The observed pattern of increased functional connectivity in core resting state networks correlated with reduced cognitive performance on all cognitive domains tested and with a heavy focus on DM, CE, and DM–CE in the NP subgroup. Furthermore, we found that the observed alterations in memory and psychomotor speed correlated with disease duration. In SLE patients both with and without clinically overt neuropsychiatric manifestations, we found changes in the functional connectivity of core resting state networks essential to cognitive functions. These findings may represent a rewiring of functional architecture in response to neuronal damage and could indicate suboptimal compensatory mechanisms at play.

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“…Neuroimaging and cognitive correlates of NPSLE have been examined with magnetic resonance imaging (MRI) in order to understand its mechanisms. MRI experiments have demonstrated NPSLE‐associated alterations, including white matter hyperintensities suggestive of vascular disease and diffuse gray matter lesions that may be consequent to immunological responses or seizures .…”

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confidence: 99%

Brain morphology and cortical thickness variations in systemic lupus erythematosus patients: Differences among neurological, psychiatric, and nonneuropsychiatric manifestations

Zimmermann

Corrêa

Tukamoto

et al. 2016

J. Magn. Reson. Imaging

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Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Cited by 30 publications

References 53 publications

Longitudinal evaluation of diffusion tensor imaging and cognition in systemic lupus erythematosus

Longitudinal evaluation of diffusion tensor imaging and cognition in systemic lupus erythematosus

Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

Brain morphology and cortical thickness variations in systemic lupus erythematosus patients: Differences among neurological, psychiatric, and nonneuropsychiatric manifestations

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