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Microembolic Signals in Patients with Systemic Lupus Erythematosus

Published online by Cambridge University Press:  02 December 2014

Mahmoud Reza Azarpazhooh ,
Naghmeh Mokhber ,
Elias Orouji ,
Brian R. Chambers ,
Mohammad Reza Hatef ,
Zahra Rezaieyazdi ,
Sima Sedighi ,
Mohsen Foroghipoor ,
Arash Velayati  and
Morteza Modares Gharavi
Mahmoud Reza Azarpazhooh
Affiliation:
Department of Neurology, Mashhad, Iran
Naghmeh Mokhber
Affiliation:
Department of Psychiatry, Avicenna Hospital, Mashhad, Iran
Elias Orouji
Affiliation:
Mashhad University of Medical Sciences, Mashhad, Iran
Brian R. Chambers
Affiliation:
Austin Health, National Stroke Research Institute, Victoria, Australia
Mohammad Reza Hatef*
Affiliation:
Department of Rheumatology, Emam Reza Hospital, Mashhad, Iran
Zahra Rezaieyazdi
Affiliation:
Department of Rheumatology, Ghaem Medical Center, Mashhad, Iran
Sima Sedighi
Affiliation:
Department of Rheumatology, Ghaem Medical Center, Mashhad, Iran
Mohsen Foroghipoor
Affiliation:
Department of Neurology, Mashhad, Iran
Arash Velayati
Affiliation:
Department of Neurology, Mashhad, Iran
Morteza Modares Gharavi
Affiliation:
Department of Psychiatry, Avicenna Hospital, Mashhad, Iran
*
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Science, Taghi Abad Square, Mashhad, Iran.
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Abstract

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Introduction:

Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.

Methods and Materials:

Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.

Results:

MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).

Conclusions:

MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 3 , May 2010 , pp. 371 - 375
Copyright
Copyright © The Canadian Journal of Neurological 2010

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