Study of MRI brain findings and carotid US features in systemic sclerosis patients, relationship with disease parameters

Abstract

Background/objectives Systemic sclerosis (SSc) is an autoimmune disease associated with immune abnormalities and widespread vascular lesions, including increased intimal and medial thickness. These changes may be reflected in early atherosclerosis and cardiovascular risks. We aimed in this study to examine the carotid artery intima-media thickness and MRI brain findings in SSc patients and compared them to a group of normal controls. A relationship between these parameters and clinical measures in SSc was also sought. Methods Seventy-two SSc patients with no central nervous system (CNS) symptoms and 42 healthy controls were included. Clinical and laboratory measures, Medsger’s severity scale, and Doppler ultrasound common carotid artery intima-media thickness (CCA-IMT) were measured. Brain fluid-attenuated inversion recovery (FLAIR)-MRI and diffusion-weighted MRI (DWI) were also done. Results SSc patients had more CCA-IMT, higher CRP, and more brain MRI hyperintense lesions than controls ( P < 0.05). Significant positive correlations existed between CCA-IMT and Medsger vascular ( r = 0.7, P = 0.02). The FLAIR-MRI showed multiple hyperintense lesions in 24 patients (33%), ranging 0–36 lesions. SSc patients with more lesions (positive MRI) had longer disease duration ( P = 0.001) and left and right carotid artery atheromata ( P = 0.001, and 0.013, respectively) than SSc patients with negative MRIs; Medsger vascular score did not separate the SSc groups ( P = 0.08). Conclusions In systemic sclerosis patients without central nervous system symptoms, MRI lesion numbers correlated with CCA-IMT. MRI abnormalities were found more frequently if CRP was elevated, if the Medsger SSc Severity Scale was increased, or if there was thickened carotid IMT.

Towards an understanding of women's brain aging: the immunology of pregnancy and menopause

“…Women are in general more frequently affected by autoimmune diseases than men [11,12], and the female to male ratio has been shown to be 3:1 for multiple sclerosis (MS), 7:1 for rheumatoid arthritis (RA), and up to 16:1 for Sjögren's syndrome [13]. Some autoimmune diseases have considerable impact on brain structure [14,15,16,17,18,19,20], and may accelerate neural aging processes [21,22,23,24].…”

Role of cognitive impairment and malnutrition as determinants of quality of life in patients with systemic sclerosis

“…Vasculopathy, both microangiopathic and macroangiopathic, is thought to trigger the onset and progression of cognitive decline in SSc patients. 7,8,29 Indeed, patients with SSc have higher cardiovascular and cerebrovascular morbidity, mainly determined by accelerated atherosclerosis. 9…”

“…6 Vasculopathy, both macro- and microangiopathic, is thought to play a key role in determining the onset and progression of cognitive decline. 7,8 Indeed, patients with SSc have higher cardiovascular and cerebrovascular morbidity, mainly determined by accelerated atherosclerosis. 9 Furthermore, it has been speculated that inflammation and immune response could play a role in neurological damage.…”

Longitudinal MicroSPECT Imaging of Systemic Sclerosis Model Mice with [99mTc]Tc-HYNFA via Folate Receptor Targeting

“…Various imaging technologies have been used to detect morphological and functional analysis of microcirculation such as power doppler ultrasonography, raster-scanning optoacoustic microscopy, optoacoustic imaging, raster-scanning optoacoustic microscopy, and optical coherence tomography (OCT) . MRI has obvious advantages for finding abnormalities in the cases of elevated C-reactive protein, increased Medsger SSc Severity Scale, or thickened carotid artery intima-media thickness . These imaging methods are designed to detect microcirculation but not to assess deep inflammatory lesions.…”

“…15 MRI has obvious advantages for finding abnormalities in the cases of elevated C-reactive protein, increased Medsger SSc Severity Scale, or thickened carotid artery intima-media thickness. 16 These imaging methods are designed to detect microcirculation but not to assess deep inflammatory lesions.…”