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July2013 Vol.50 Issue:        3       (Supp.) Table of Contents
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Evaluation of Cerebral Hemodynamics and its Impact on Cognitive Screening Test in SLE Patients

Ahmed T. El-Ghoneimy1, Nirmeen A. Kishk1, Abeer Nabil2, Marwa Farghaly1,

Yahia Zakaria1, Nagwa Ramadan3, Mohamed Raslan1

Departments of Neurology1, Rheumatology2, Internal Medicine3, Cairo University; Egypt



ABSTRACT

Background: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease targets the vascular system resulting in vasculitis, vasculopathy, and premature atherosclerosis. Vascular affection is one of the proposed pathogenic mechanisms for neuropsychiatric lupus. Objective: The purpose of this study was to measure the total cerebral blood flow volume (TCBFV) in patients with SLE using Doppler ultrasonography and to determine whether a relationship exists between cerebral perfusion changes with disease activity and cognitive screening tests. Subjects and Methods: This study was conducted on twenty-one SLE female patients diagnosed according to the modified American College of Rheumatology revised criteria of SLE. Ten age-matched female volunteers served as the control group. All subjects were assessed using Modified Mini-Mental State as a neuropsychological screening test. Cerebral blood flow was assessed by extra- cranial Doppler ultrasonography to calculate TCBFV. Results: TCBFV was lower in patients’ than in the control group but not statistically significant. A significant lower CBFV in Left Internal Carotid Artery in patients’ group compared to the control group (p 0.05). The cerebral perfusion was significantly lower in patients with active disease (p 0.01). There was no statistically significant difference between patients with neuropsychiatric lupus (NPSLE) compared to Non NPSLE or between patients with antiphospholipid syndrome (APS) and without APS; regarding their TCBV .SLE patients had subcortical pattern of cognitive impairment. Conclusion: Using ultrasound for measuring TCBFV cannot detect evident cerebral hypoperfusion. However, lower TCBFV in SLE patients is associated with more disease activity, but not related to the cognitive dysfunction. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(3): 213-220]

Key Words: Systemic Lupus Erythematosus, Doppler ultrasonography, Cerebral blood flow volume, cognitive screening test, SLEDAI.

Correspondence to Nirmeen A.Kishk, Department of Neurology, Cairo University, Egypt.

Tel.: +201001128585      Email: nirmeenkishk@hotmail.com





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