White Matter Water Diffusion Changes in Primary Sjogren Syndrome

Tzarouchi, Loukia; Zikou, Anastasia; Tsifetaki, Niki; Astrakas, Loukas G.; Konitsiotis, Spyridon; Drosos, Alexandros A.; Argyropoulou, M. I.

doi:10.3174/ajnr.a3756

Cited by 21 publications

(19 citation statements)

References 41 publications

(70 reference statements)

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“…One of these cases had Sjögren's syndrome, like our patient,3 but not the other two 24. In addition, although some studies have found cerebral white-matter lesions in Sjögren's syndrome,67 leukodystrophy-like white-matter changes have not been reported previously. Given that two of the three reported NMOSD cases were not associated with Sjögren's syndrome and leukodystrophy-like white-matter lesions in Sjögren's syndrome alone were not previously reported, the brain lesions of our patient were more likely to be related to current NMOSD than Sjögren's syndrome.…”

contrasting

confidence: 52%

A Little-Known Brain Imaging Feature in Neuromyelitis Optica Spectrum Disorder: A Leukodystrophy-Like Pattern

et al. 2019

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contrasting

confidence: 52%

A Little-Known Brain Imaging Feature in Neuromyelitis Optica Spectrum Disorder: A Leukodystrophy-Like Pattern

et al. 2019

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“…Studies of other inflammatory autoimmune diseases show a similar pattern of findings, for example, in Sjögren Syndrome ( n =19; method = TBSS) there was increased MD and decreased FA in several tracts compared to controls. 38 …”

Section: Discussionmentioning

confidence: 99%

Fatigue and cognitive function in systemic lupus erythematosus: associations with white matter microstructural damage. A diffusion tensor MRI study and meta-analysis

Wiseman

Bastin

Hamilton

et al. 2016

Lupus

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Objective To investigate fatigue and cognitive impairments in systemic lupus erythematous (SLE) in relation to diffuse white matter microstructural brain damage. Methods Diffusion tensor MRI, used to generate biomarkers of brain white matter microstructural integrity, was obtained in patients with SLE and age-matched controls. Fatigue and cognitive function were assessed and related to SLE activity, clinical data and plasma biomarkers of inflammation and endothelial dysfunction. Results Fifty-one patients with SLE (mean age 48.8 ± 14.3 years) were included. Mean diffusivity (MD) was significantly higher in all white matter fibre tracts in SLE patients versus age-matched healthy controls (p<0.0001). Fatigue in SLE was higher than a normal reference range (p<0.0001) and associated with lower MD (β = −0.61, p=0.02), depression (β = 0.17, p=0.001), anxiety (β = 0.13, p=0.006) and higher body mass index (β = 0.10, p=0.004) in adjusted analyses. Poorer cognitive function was associated with longer SLE disease duration (p=0.003) and higher MD (p=0.03) and, in adjusted analysis, higher levels of IL-6 (β = −0.15, p=0.02) but not with MD. Meta-analysis (10 studies, n=261, including the present study) confirmed that patients with SLE have higher MD than controls. Conclusion Patients with SLE have more microstructural brain white matter damage for age than the general population, but this does not explain increased fatigue or lower cognition in SLE. The association between raised IL-6 and worse current cognitive function in SLE should be explored in larger datasets.

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“…In a small study of asymptomatic SS patients, white matter lesions were found in a higher burden than in age-matched controls, with multiple white matter tracts involved including the corticospinal tracts, superior longitudinal fasciculus, the anterior thalamic radiation, the inferior frontooccipital fasciculus, the uncinate fasciculus, and the inferior longitudinal fasciculus. 40 Historically, SS was thought to be a potential cause of relapsing-remitting symptoms in patients presenting with demyelinating appearing lesions in the brain, optic nerves, and/or spinal cord. Now, with the recognition of neuromyelitis optica spectrum disorders (NMOSD; discussed in article Autoimmune Neurologic Diseases in Children), it is likely that many of these SS patients in fact had underlying aquaporin-4 (AQP4) antibodies.…”

Section: Sjögren's Syndromementioning

confidence: 99%

Infection, Immunodeficiency, and Inflammatory Diseases in Autoimmune Neurology

Piquet¹,

Clardy

2018

Semin Neurol

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When patients present with neurological syndromes, such as encephalopathy/encephalitis, meningitis, and/or myelopathy/myelitis, the differential diagnosis is often broad, including infectious, inflammatory, autoimmune, vascular, and neoplastic etiologies. Just with inflammatory and autoimmune etiologies alone, there are numerous causative diseases. A comprehensive history and physical examination investigating for extraneurologic manifestations of immune-mediated disease is often necessary. Moreover, evaluating for an underlying infection and/or immunodeficiency becomes a critical aspect to the workup. This article will focus on the association of viral infections and dysregulation of the immune system as triggers of autoimmunity, in addition to various systemic inflammatory diseases that can cause neurological disease either with or without an established rheumatological disorder.

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White Matter Water Diffusion Changes in Primary Sjogren Syndrome

Abstract: BACKGROUND AND PURPOSE:Histopathologic studies have demonstrated WM damage in primary Sjögren syndrome. The purpose of this study was to evaluate WM microstructural changes by use of DTI-derived parameters in patients with primary Sjögren syndrome.

Cited by 21 publications

References 41 publications

A Little-Known Brain Imaging Feature in Neuromyelitis Optica Spectrum Disorder: A Leukodystrophy-Like Pattern

A Little-Known Brain Imaging Feature in Neuromyelitis Optica Spectrum Disorder: A Leukodystrophy-Like Pattern

Fatigue and cognitive function in systemic lupus erythematosus: associations with white matter microstructural damage. A diffusion tensor MRI study and meta-analysis

Infection, Immunodeficiency, and Inflammatory Diseases in Autoimmune Neurology

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