Cerebral and Cerebellar Volume Loss in Children and Adolescents with Systemic Lupus Erythematosus: A Review of Clinically Acquired Brain Magnetic Resonance Imaging

Muscal, Eyal; Traipe, Elfrides; Guzman, Marietta M. de; Myones, Barry L.; Brey, Robin L.; Hunter, Jill V.

doi:10.3899/jrheum.090983

Cited by 23 publications

(39 citation statements)

References 31 publications

(24 reference statements)

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“…Cortical atrophy may be secondary to inflammatory mediators, as for example in Maremma Shepherd or Rottweiler dogs; however, neither eosinophilic involvement nor inflammatory processes are present in Greyhounds affected by Greyhound nonsuppurative meningoencephalitis. Cortical brain atrophy, commonly seen in humans with inflammatory brain lesions independent of the cause, is a nonspecific response to the irreversible neurologic injury . This suggests that as brain tissue degenerates, atrophy may be observed.…”

Section: Discussionmentioning

confidence: 99%

Unique Topographic Distribution of Greyhound Nonsuppurative Meningoencephalitis

Terzo

McConnell

Shiel

et al. 2012

Vet Radiology Ultrasound

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Greyhound nonsuppurative meningoencephalitis is an idiopathic breed-associated fatal meningoencephalitis with lesions usually occurring within the rostral cerebrum. This disorder can only be confirmed by postmortem examination, with a diagnosis based upon the unique topography of inflammatory lesions. Our purpose was to describe the magnetic resonance (MR) imaging features of this disease. Four Greyhounds with confirmed Greyhound nonsuppurative meningoencephalitis were evaluated by MR imaging. Lesions predominantly affected the olfactory lobes and bulbs, frontal, and frontotemporal cortical gray matter, and caudate nuclei bilaterally. Fluid attenuation inversion recovery (FLAIR) and T2 weighted spin-echo (T2W) sequences were most useful to assess the nature, severity, extension, and topographic pattern of lesions. Lesions were predominantly T2-hyperintense and T1-isointense with minimal or absent contrast enhancement. C 2012 Veterinary Radiology & Ultrasound.

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Section: Discussionmentioning

confidence: 99%

Unique Topographic Distribution of Greyhound Nonsuppurative Meningoencephalitis

Terzo

McConnell

Shiel

et al. 2012

Vet Radiology Ultrasound

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“…When the CC is involved, the splenium is preferentially affected and lesions tend to be transient, located in the midline and related to disease activity (see transient splenial lesions) 61–65. In addition, patients with SLE tend to have reduced corpus callosal volume when compared to healthy controls 66 67…”

Section: Non-demyelinating Neuroinflammatory Diseasesmentioning

confidence: 99%

The corpus callosum in the diagnosis of multiple sclerosis and other CNS demyelinating and inflammatory diseases

Garg

Miller

et al. 2015

J Neurol Neurosurg Psychiatry

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Lesions in the corpus callosum (CC) are important radiological clues to the diagnosis of multiple sclerosis (MS), but may also occur in other neuroinflammatory and non-neuroinflammatory conditions. In this article, we discuss the radiological features of lesions within the CC in MS and other central nervous system inflammatory and acquired demyelinating diseases. An understanding of the appearance and location of lesions in the CC is important not only for accurate diagnosis and treatment of these various conditions, but as it also provides insights into pathogenesis.

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“…Previous studies have demonstrated global volume loss in patients with new-onset SLE, suggesting an immunologic basis for volume reduction, independent of corticosteroid use (6,7). The association of cerebral volume loss and antiphospholipid antibodies has been described in patients with adult-onset SLE (37); however, this was not observed in a previous study of a childhood-onset SLE cohort (6).…”

Section: Discussionmentioning

confidence: 91%

“…The CNS involvement has been described to occur in 25-90% of those with childhood-onset SLE, depending on the diagnostic criteria applied, the type of manifestations included, and the evaluation method (1)(2)(3). Magnetic resonance imaging (MRI) is still the gold standard for evaluating CNS involvement in SLE, and several studies have shown both focal and diffuse brain atrophy (4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

Reduction of Cerebral and Corpus Callosum Volumes in Childhood‐Onset Systemic Lupus Erythematosus: A Volumetric Magnetic Resonance Imaging Analysis

Lapa

Postal

Sinicato

et al. 2016

Arthritis & Rheumatology

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Objective. There have been few studies in which the prevalence of cerebral atrophy in childhood-onset systemic lupus erythematosus (SLE) was evaluated using magnetic resonance imaging (MRI) volumetric measurements. This study was undertaken to determine the prevalence of cerebral and corpus callosum atrophy in childhood-onset SLE and to determine the possible relationships between atrophy and clinical, laboratory, and treatment features of the disease.Methods. We included 76 patients with childhoodonset SLE (69 female and 7 male; median age 16 years) and 66 age-and sex-matched healthy controls. Neurologic manifestations were analyzed according to the American College of Rheumatology (ACR) criteria. These SLE patients were further assessed for clinical and laboratory manifestations of SLE, disease activity (using the SLE Disease Activity Index), damage (using the Systemic Lupus International Collaborating Clinics/ACR Damage Index), and current and cumulative drug exposures. Scans were performed with a Philips 3.0T MRI scanner using a standardized protocol.Results. Childhood-onset SLE patients had significantly smaller cerebral and corpus callosum volumes than controls (median cerebral volume 1,067.9 cm 3 versus 1,172.7 cm 3 and median corpus callosum volume 11.6 cm 3 versus 13.7 cm 3 ; P < 0.001). The presence of structural abnormalities was observed in 42 patients (55.3%) with childhood-onset SLE. The presence of cerebral atrophy was associated with anticardiolipin antibodies (aCL) (P 5 0.02), anti-double-stranded DNA (P 5 0.02), and cumulative corticosteroid dose (P 5 0.04). The presence of corpus callosum atrophy was associated with low complement level (P 5 0.006) and acute confusional state (P 5 0.01). Serum levels of S100B or high molecular weight neurofilament and the presence of anti-ribosomal P were not associated with atrophy.Conclusion. Structural brain abnormalities were observed in 55.3% of the patients and were associated with neuropsychiatric manifestations, aCL, and corticosteroid use. To determine permanent neurologic damage, longitudinal studies must be conducted in these patients.Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease characterized by various clinical manifestations. Approximately 15-20% of patients with SLE develop the disease in childhood or adolescence (1,2). Clinical and laboratory manifestations in adult and childhood-onset SLE are similar; however, in childhood-onset SLE there is a higher prevalence and severity of some manifestations, especially nephritis and

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Cerebral and Cerebellar Volume Loss in Children and Adolescents with Systemic Lupus Erythematosus: A Review of Clinically Acquired Brain Magnetic Resonance Imaging

Abstract: Regional volume loss was observed in most adolescents with lupus undergoing clinical brain MRI scans. As in other pediatric conditions with inflammatory or vascular etiologies, these findings may be reflecting disease-associated neuronal loss and not solely the effects of corticosteroid.

Cited by 23 publications

References 31 publications

Unique Topographic Distribution of Greyhound Nonsuppurative Meningoencephalitis

Unique Topographic Distribution of Greyhound Nonsuppurative Meningoencephalitis

The corpus callosum in the diagnosis of multiple sclerosis and other CNS demyelinating and inflammatory diseases

Reduction of Cerebral and Corpus Callosum Volumes in Childhood‐Onset Systemic Lupus Erythematosus: A Volumetric Magnetic Resonance Imaging Analysis

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