Brain diffusion tensor MRI in systematic lupus erythematosus: A systematic review

Costallat, Beatriz Lavras; Ferreira, Daniel Miranda; Lapa, Aline Tamires; Rittner, Letícia; Costallat, Lílian Tereza Lavras; Appenzeller, Simone

doi:10.1016/j.autrev.2017.11.008

Cited by 33 publications

(29 citation statements)

References 31 publications

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“…Together with our finding of abnormal perfusion in the corpus callosum, these findings indicated that the corpus callosum was one of the fibers specifically damaged in SLE patients. This damage was more pronounced in NPSLE patients, indicating that the corpus callosum measurement could be a sensitive biomarker for defining NPSLE (Costallat et al, ; Lee et al, ; Wang et al, ). This perfusion pattern in the corpus callosum needs to be validated in a large sample with a longitudinal design and has the potential to be an imaging biomarker for defining SLE patients vulnerable to progress to NPSLE.…”

Section: Discussionmentioning

confidence: 99%

Different patterns of cerebral perfusion in SLE patients with and without neuropsychiatric manifestations

Zhuo

Duan

et al. 2019

Human Brain Mapping

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To investigate brain perfusion patterns in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric systemic lupus erythematosus (NPSLE and non-NPSLE, respectively) and to identify biomarkers for the diagnosis of NPSLE using noninvasive three-dimensional (3D) arterial spin labeling (ASL). Thirty-one NPSLE and 24 non-NPSLE patients and 32 age-and sex-matched normal controls (NCs) were recruited. Three-dimensional ASL-MRI was applied to quantify cerebral perfusion. Whole brain, gray (GM) and white matter (WM), and voxel-based analysis (VBA) were performed to explore perfusion characteristics. Correlation analysis was performed to find the relationship between the perfusion measures, lesion volumes, and clinical variables. Receiver operating characteristic (ROC) analysis and support vector machine (SVM) classification were applied to differentiate NPSLE patients from non-NPSLE patients and healthy controls. Compared to NCs, NPSLE patients showed increased cerebral blood flow (CBF) within WM but decreased CBF within GM, while non-NPSLE patients showed increased CBF within both GM and WM. Compared to non-NPSLE patients, NPSLE patients showed significantly reduced CBF in the frontal gyrus, cerebellum, and corpus callosum. CBF within several brain regions such as cingulate and corpus callosum showed significant correlations with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborating Clinics (SLICC) damage index scores. ROC analysis showed moderate performance in distinguishing NPSLE from non-NPSLE patients with AUCs > 0.7, while SVM analysis demonstrated that CBF within the corpus callosum achieved an accuracy of 83.6% in distinguishing NPSLE from non-NPSLE patients. Different brain perfusion patterns were observed between NPSLE and non-NPSLE patients. CBF measured by noninvasive 3D ASL could be a useful biomarker for the diagnosis and disease monitoring of NPSLE and non-NPSLE patients. K E Y W O R D S 3D arterial spin labeling, neuropsychiatric systemic lupus erythematosus, perfusion, systemic lupus erythematosus Zhizheng Zhuo and Li Su contributed equally to this study.

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Section: Discussionmentioning

confidence: 99%

Different patterns of cerebral perfusion in SLE patients with and without neuropsychiatric manifestations

Zhuo

Duan

et al. 2019

Human Brain Mapping

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“…- Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI): Abnormal water diffusivity in brain white matter in NP-SLE has been reported in several studies (2, 76–80) and a review that summarizes many of these findings has been recently published (81). Global and local microstructural abnormalities, reflected in increase in mean diffusivity (MD) and decrease in fractional anisotropy (FA), were reported in most of the studies selected in this review.…”

Section: The Challenges Of Establishing a Neuroimaging Biomarker In Nmentioning

confidence: 99%

Laboratory and Neuroimaging Biomarkers in Neuropsychiatric Systemic Lupus Erythematosus: Where Do We Stand, Where To Go?

et al. 2018

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multi-systemic involvement. Nervous system involvement in SLE leads to a series of uncommon and heterogeneous neuropsychiatric (NP) manifestations. Current knowledge on the underlying pathogenic processes and their subsequent pathophysiological changes leading to NP-SLE manifestations is incomplete. Several putative laboratory biomarkers have been proposed as contributors to the genesis of SLE-related nervous system damage. Alongside the laboratory biomarkers, several neuroimaging tools have shown to reflect the nature of tissue microstructural damage associated with SLE, and thus were suggested to contribute to the understanding of the pathophysiological changes and subsequently help in clinical decision making. However, the number of useful biomarkers in NP-SLE in clinical practice is disconcertingly modest. In some cases it is not clear whether the biomarker is truly involved in pathogenesis, or the result of non-specific pathophysiological changes in the nervous system (e.g., neuroinflammation) or whether it is the consequence of a concomitant underlying abnormality related to SLE activity. In order to improve the diagnosis of NP-SLE and provide a better targeted care to these patients, there is still a need to develop and validate a range of biomarkers that reliably capture the different aspects of disease heterogeneity. This article critically reviews the current state of knowledge on laboratory and neuroimaging biomarkers in NP-SLE, discusses the factors that need to be addressed to make these biomarkers suitable for clinical application, and suggests potential future research paths to address important unmet needs in the NP-SLE field.

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“…Several cross-sectional studies of DTI in NPSLE and SLE patients without neuropsychiatric symptoms, compared with healthy controls, suggest an overall decrease in WM integrity in both SLE groups (reviewed in ref. 17). However, combining imaging results for all NPSLE syndromes precludes the ability to evaluate individual CNS manifestations in the context of proposed biologic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Metabolic and microstructural alterations in the SLE brain correlate with cognitive impairment

Mackay¹,

Tang

et al. 2019

JCI Insight

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Brain diffusion tensor MRI in systematic lupus erythematosus: A systematic review

Cited by 33 publications

References 31 publications

Different patterns of cerebral perfusion in SLE patients with and without neuropsychiatric manifestations

Different patterns of cerebral perfusion in SLE patients with and without neuropsychiatric manifestations

Laboratory and Neuroimaging Biomarkers in Neuropsychiatric Systemic Lupus Erythematosus: Where Do We Stand, Where To Go?

Metabolic and microstructural alterations in the SLE brain correlate with cognitive impairment

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