Evidence of cerebral hypoperfusion in scleroderma patients

Cutolo, Maurizio; Nobili, Flavio; Sulli, Alberto; Pizzorni, Carmen; Briata, M.; Faelli, F.; Vitali, Paolo; Mariani, G; Copello, F; Seriolo, Bruno; Barone, Carlo; Rodriguez, Guido

doi:10.1093/rheumatology/39.12.1366

Cited by 56 publications

(25 citation statements)

References 30 publications

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“…Cutolo et al have recently found focal or diffuse cerebral hypoperfusion in more than half of their neurologically asymptomatic patients with SSc as assessed by SPECT. 19 However, they attributed the low fibrosis in the brain to the absence of advanced vascular damage. Their results seem to support our finding, which showed no correlation between retinal and nailfold capillary changes.…”

Section: Discussionmentioning

confidence: 99%

Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns

Ushiyama¹

2003

Annals of the Rheumatic Diseases

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Section: Discussionmentioning

confidence: 99%

Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns

Ushiyama¹

2003

Annals of the Rheumatic Diseases

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“…The NVC patterns have been correlated with different clinical aspects and manifestations of SSc, as well as to the effects of treatment, contributing to the overall study of the disease [32][33][34][35][36].…”

Section: The "Scleroderma-pattern": the Reference Patternmentioning

confidence: 99%

Nailfold video-capillaroscopy in systemic sclerosis

2004

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The Raynaud's phenomenon (RP) is the most common and significant clinical condition supporting microvascular analysis as soon as possible. Microvascular involvement is a key feature of RP, and several rheumatic diseases are characterized by the presence of the RP. Nailfold capillary microscopy shows an impressive cost/effectiveness ratio: it is simple, noninvasive and inexpensive.Well-recognized videocapillaroscopic patterns (NVC) have been described mainly in scleroderma (SSc) patients complaining of a secondary RP. The peripheral microvascular damage in SSc is characterized by increasing structural alterations of the capillaries (giant capillaries and microhemorrhages) with progressive decrease of their density. The detection of the scleroderma NCV allows early differentiation between primary RP (functional, not disease associated), and secondary RP (disease associated). Other major NVC patterns have been described in the field of rheumatic diseases. Interestingly, correlations are evident between the NCV and the clinical symptoms, severity of the disease and the laboratory findings. Further clinical and epidemiological studies, as well as a standardized and computerized quantitation of the observed damages are required.

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“…Neuropsychiatric manifestations, such as loss of memory, disorientation, depression, delusions, hallucinations, and reduced mental acuity were reported in the late phase of the disease, while transient ischemic attacks, ischemic stroke, and hemorrhage have been described as a primary consequence of SSc in recent years, and recent evidences support that vascular CNS involvement in scleroderma is not uncommon and these features might be asymptomatic and independent of disease duration [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Brain MRI screening showing evidences of early central nervous system involvement in patients with systemic sclerosis

2010

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Systemic sclerosis is a multisystem autoimmune collagen disease where structural and functional abnormalities of small blood vessels prevail. Transient ischemic attacks, ischemic stroke, and hemorrhage have been reported as primary consequence of vascular central nervous system affection in systemic sclerosis. Magnetic resonance imaging is considered to be the most sensitive diagnostic technique for detecting symptomatic and asymptomatic lesions in the brain in cases of multifocal diseases. The objective of this study is to detect subclinical as well as clinically manifest cerebral vasculopathy in patients with systemic sclerosis using magnetic resonance imaging. As much as 30 female patients with systemic sclerosis aged 27-61 years old, with disease duration of 1-9 years and with no history of other systemic disease or cerebrovascular accidents, were enrolled. Age-matched female control group of 30 clinically normal subjects, underwent brain magnetic resonance examination. Central nervous system (CNS) involvement in the form of white matter hyperintense foci of variable sizes were found in significantly abundant forms in systemic sclerosis patients on magnetic resonance evaluation than in age-related control group, signifying a form of CNS vasculopathy. Such foci showed significant correlation to clinical features of organic CNS lesion including headaches, fainting attacks and organic depression as well as to the severity of peripheral vascular disease with insignificant correlation with disease duration. In conclusion, subclinical as well as clinically manifest CNS ischemic vasculopathy is not uncommon in systemic sclerosis patients and magnetic resonance imaging is considered a sensitive noninvasive screening tool for early detection of CNS involvement in patients with systemic sclerosis.

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Evidence of cerebral hypoperfusion in scleroderma patients

Cited by 56 publications

References 30 publications

Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns

Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns

Nailfold video-capillaroscopy in systemic sclerosis

Brain MRI screening showing evidences of early central nervous system involvement in patients with systemic sclerosis

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