A meta-analysis of structural MRI studies of the brain in systemic lupus erythematosus (SLE)

Abstract

A comprehensive search of published literature in brain volumetry was conducted in three autoimmune diseases — systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and ulcerative colitis (UC) — with the intention of performing a meta-analysis of published data. Due to the lack of data in RA and UC, the reported meta-analysis was limited to SLE. The MEDLINE database was searched for studies from 1988 to March 2022. A total of 175 papers met the initial inclusion criteria, and 16 were included in a random-effects meta-analysis. The reduction in the number of papers included in the final analysis is primarily due to the lack of overlap in measured and reported brain regions. A significantly lower volume was seen in patients with SLE in the hippocampus, corpus callosum, and total gray matter volume measurements as compared to age- and sex-matched controls. There were not enough studies to perform a meta-analysis for RA and UC; instead, we include a summary of published volumetric studies. The meta-analyses revealed structural brain abnormalities in patients with SLE, suggesting that lower global brain volumes are associated with disease status. This volumetric difference was seen in both the hippocampus and corpus callosum and total gray matter volume measurements. These results indicate both gray and white matter involvements in SLE and suggest there may be both localized and global reductions in brain volume.

P40 Medial temporal lobe subregion volumes in systemic lupus erythematosus patients

“…1 Zahra M Najeeb, 2 Andreas Jönsen, 2,3 Kristoffer Zervides, 3 Petra C Nilsson, 2 Anders Bengtsson, 1 Tim Salomonsson, 4,5 Gregory Kuchcinski, 1,6,7 Pia C Sundgren, Objective Systemic lupus erythematosus (SLE) often presents with neuropsychiatric (NP) symptoms, including cognitive impairment and depression. Past magnetic resonance imaging (MRI) research on hippocampal (HC) volumes, important for NP symptoms, in SLE patients yielded conflicting results and did not investigate other medial temporal lobe (MTL) regions.…”

“…Past magnetic resonance imaging (MRI) research on hippocampal (HC) volumes, important for NP symptoms, in SLE patients yielded conflicting results and did not investigate other medial temporal lobe (MTL) regions. 1 Our study aims to compare MTL subregional volumes in SLE patients to healthy individuals (HI) and explore the relationship between MTL subregional volume, cognition, and depression in SLE patients. Methods 70 SLE patients (mean age 36 years (range 18-51), mean disease duration 11.1 ± 8.0 years) and 25 HI (mean age 37.2 years (range 23-52)) underwent clinical evaluation, cognitive testing using CNS Vital Signs (CNS-VS), and 3 tesla MRI.…”

Cardiac sarcoidosis and neurosarcoidosis – multidisciplinary approach for diagnosis

“…Involvement of the spinal cord, basal meninges or cranial nerves tends to favour NS over primary CNS vasculitis [62]. Structural brain abnormalities in patients with systemic lupus erythematosus are often detected in patients with similar original presentation [63]. Granulomatosis with polyangiitis and neuro-Behcet's disease can also present with white matter lesions and a pachymeningitis [64].…”

Immunoception: the insular cortex perspective

“…This central representation of the immune system is expected to be manifested across multiple brain modules that can encompass the complexity of the immune response. Indeed, it was shown that peripheral inflammation results in increased activity across the entire brain [14][15][16]. Here, we will focus on the IC, or insula, considered the "primary interoceptive cortex" [4] and highlight some of this region's unique properties, positioning the IC as a key component in immunoception.…”

“…It is now well established that the brain responds to changes in peripheral inflammation [14][15][16]. The most intuitive example is sickness behavior, in which physiological and behavioral processes, including sleep, appetite, mood, and cognition, are altered during inflammation or infection [32][33][34][35][36].…”