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