Quantitative magnetic resonance imaging analyses and clinical significance of hyperintense white matter lesions in systemic lupus erythematosus patients

Appenzeller, Simone; Faria, Andrea Vasconcelos; Li, Li Min; Costallat, Lilian T. L.; Cendes, Fernando

doi:10.1002/ana.21483

Cited by 96 publications

(118 citation statements)

References 61 publications

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“…33,34 Numerous studies have also revealed WM abnormalities in patients with NPSLE, 35,36 including the presence of WM lesions 37 and increased WM tract diffusivity. 38 The pathogenesis of CNS involvement in SLE is likely related to an inflammatory response secondary to auto-antibody-mediated vasculitis.…”

Section: Discussionmentioning

confidence: 99%

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

Cesar

Dwyer

Shucard³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Multiple sclerosis and neuropsychiatric systemic lupus erythematosus are autoimmune diseases with similar CNS inflammatory and neurodegenerative characteristics. Our aim was to investigate white matter tract changes and their association with cognitive function in patients with MS and those with neuropsychiatric systemic lupus erythematosus compared with healthy controls by using diffusion tensor imaging.

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Section: Discussionmentioning

confidence: 99%

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

Cesar

Dwyer

Shucard³

et al. 2015

AJNR Am J Neuroradiol

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“…In a recent study in patients with newly diagnosed SLE, WMH were found in 8% of the patients 38 . Nevertheless, these lesions were observed more frequently in NPSLE when compared with SLE without neuropsychiatric manifestations, with average ranges from 40 to 60% 8, 11, 19, 34, 36, 38, 39 . WMH were associated with cerebrovascular disease, cognitive dysfunction, seizures, antiphospholipid antibodies, low complements (C3, C4, CH50), age, disease duration, and total corticosteroid dose 8, 34 .…”

Section: Introductionmentioning

confidence: 94%

“…Nevertheless, these lesions were observed more frequently in NPSLE when compared with SLE without neuropsychiatric manifestations, with average ranges from 40 to 60% 8, 11, 19, 34, 36, 38, 39 . WMH were associated with cerebrovascular disease, cognitive dysfunction, seizures, antiphospholipid antibodies, low complements (C3, C4, CH50), age, disease duration, and total corticosteroid dose 8, 34 . Previous reports demonstrated a significant association between both NPSLE activity (Neuro-SLEDAI) and injury (Neuro-SLICC) scores with the number of WMH (high lesion burden) 11, 34, 36, 38, 40 .…”

Section: Introductionmentioning

confidence: 94%

Magnetic Resonance Imaging in Neuropsychiatric Lupus

2015

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Neuropsychiatric lupus is a major diagnostic challenge, and a main cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is, by far, the main tool for assessing the brain in this disease. Conventional and advanced MRI techniques are used to help establishing the diagnosis, to rule out alternative diagnoses, and recently, to monitor the evolution of the disease. This review explores the neuroimaging findings in SLE, including the recent advances in new MRI methods.

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“…There is evidence that the seizures occur in the setting of brain lesions and damage to subcortical white matter following vasculitic, inflammatory, or ischemic brain injury. [56] Besides, the underlying systemic inflammatory cascades may be sufficient to cause seizures, [57] or specific antibodies to neuronal antigens may trigger seizures in some patients, although the evidence is inconclusive. [58] The development and progression of a small vessel, inflammatory vasculopathy is a hallmark of so-called ''lupus cerebritis'' or ''lupus vasculopathy. ''…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Epilepsy and Autoimmunity

Çoban¹,

Eki̇zoğlu²,

Tüzün³

2013

Epilepsi

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SummaryEpilepsy may present as a symptom of many neurological disorders and often an etiological factor cannot be identified. There is some evidence that immune mechanisms might play a role in the pathogenesis of certain epileptic syndromes. The evidence in support of this idea includes apparent association of seizures with certain autoimmune diseases, numerous reports of the detection of theoretically relevant serum autoantibodies, an acute or subacute onset of the seizures, a rapidly progressive course, and a favorable response to immunotherapy.In this article, we summarize (i) epilepsies where clinical and biologic data strongly support the pathogenic role of autoantibodies. (ii) epilepsies where immune-mediated inflammation occurs, but the full pathogenic cascade is either not clear or only strongly hypothesized and (iii) autoimmune diseases associated with seizures or epilepsy.Key words: Autoantibodies; autoimmunity; epilepsy. ÖzetEpilepsi birçok nörolojik hastalığın belirtisi olarak ortaya çıkabilir ve sıklıkla etiyolojik faktör tespit edilemez. İmmün mekanizmaların belirli epileptik sendromların patogenezinde rol oynayabileceğine dair bazı kanıtlar vardır. Belli otoimmün hastalıklar ile nöbetlerin açık bir şekilde ilişkili olması, teorik olarak uygun serum otoantikorlarının saptandığı çok sayıda bildirinin olması, akut ya da subakut başlangıçlı nöbetler, hızlı ilerleyici bir seyir ve immünoterapiye olumlu cevap alınması bu fikri destekleyen kanıtlardır. Bu makale, (i) epilepsilerin klinik ve biyolojik verilerinin otoantikorların patolojik rolünü kuvvetli bir şekilde desteklediğini (ii) epilepsilerde immün aracılı inflamasyonun oluştuğunu ancak tam patojenik kaskadın net olmadığını ya da sadece kuvvetli bir hipotez olduğunu ve (iii) epilepsi ya da nöbetlerle ilişkili otoimmün hastalıkları özetlemektedir.

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Quantitative magnetic resonance imaging analyses and clinical significance of hyperintense white matter lesions in systemic lupus erythematosus patients

Cited by 96 publications

References 61 publications

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

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

Magnetic Resonance Imaging in Neuropsychiatric Lupus

Epilepsy and Autoimmunity

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