Background: Approximately 60%
of persons diagnosed with Systemic lupus erythematosus experience neurological
complications at some time in the course of their disease. The most common of
these neurological complications is neurocognitive abnormality. This study
examined white matter structural and metabolic changes of brain in relation to
cognition in lupus patients. Methods: Twenty eight systemic lupus patients and twenty sex and age matched
healthy controls were included in this study. Magnetic resonance imaging and
magnetic resonance spectroscopy were performed and cognitive function was
assessed by Mini-Mental State Examination (MMSE). White matter structural and
metabolic measures were analyzed and correlated with cognitive function and
systemic lupus erythematosus disease activity index. Results: No significant differences were
found in total brain grey and white matter volumes or in frontal white matter
N-acetyl aspartate/creatine (NAA/Cre) and N-acetyl aspartate/choline (NAA/Cho).
Patients had significant increase Choline/Creatine (Cho/Cre) in frontal white
matter. About 57.1% SLE patients had cognitive impairment that correlated to
higher frontal white matter Cho/Cre and didn't correlate to SLE disease
activity index. Conclusions: SLE patients had
frontal white matter metabolic changes that correlated with cognitive
impairment, whereas no cerebral atrophy or white matter axonal damage was
evident. [Egypt J Neurol Psychiat
Neurosurg. 2012; 49(3): 199-206]
Key
words: Systemic lupus erythematosus, Cognition, White matter,
Magnetic Resonance Spectroscopy.
Correspondence
to Hala Haider, Physical Medicine,
Rheumatology & Rehabilitation1, Ain Shams
University; Egypt.
Tel.: +201008558846. Email:
hala_haider@yahoo.com.