Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T04:11:59.182Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive Dysfunction and White Matter Abnormalities in Systemic Lupus Erythematosus

Published online by Cambridge University Press:  22 February 2011

Elizabeth Kozora  and
Christopher M. Filley
Elizabeth Kozora*
Affiliation:
National Jewish Health, Denver, Colorado University of Colorado School of Medicine, Department of Neurology, Denver, Colorado University of Colorado School of Medicine, Department of Psychiatry, Denver, Colorado
Christopher M. Filley
Affiliation:
University of Colorado School of Medicine, Department of Neurology, Denver, Colorado University of Colorado School of Medicine, Department of Psychiatry, Denver, Colorado Denver Veterans Affairs Medical Center, Denver, Colorado
*
Correspondence and reprint requests to: Elizabeth Kozora, Ph.D., National Jewish Health, 1400 Jackson Street, Denver, CO 80206. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Brain abnormalities have been documented by neuropsychological assessment as well as a variety of neuroimaging techniques in patients with systemic lupus erythematosus (SLE). Conventional neuroimaging in patients with neuropsychiatric disease (NPSLE) typically discloses periventricular white matter (WM) hyperintensities, infarcts, hemorrhages, and cerebral atrophy. In SLE patients with none of these findings, sophisticated neuroimaging techniques have recently supported associations between microstructural WM abnormalities and abnormal attention, executive function, and processing speed. This mild cognitive dysfunction in SLE (MCD-SLE), which may result from early myelinopathy, precedes the more severe cognitive dysfunction of NPSLE, related to more obvious WM and neuronal damage. (JINS, 2011, 17, 385–392)

Keywords

LupusNeuropsychologyMagnetic resonance imagingMagnetic resonance spectroscopyMechanismsMethodology
Type
Short Reviews
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 3 , May 2011 , pp. 385 - 392
Copyright
Copyright © The International Neuropsychological Society 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abreu, M.R., Jakosky, A., Folgerini, M., Brenol, J.C., Xavier, R.M., Kapczinsky, F. (2005). Neuropsychiatric systemic lupus erythematosus: Correlation of brain MR imaging, CT, and SPECT. Clinical Imaging, 29(3), 215–221. doi:10.1016/j.clinimag.2004.07.007CrossRefGoogle ScholarPubMed
Ainiala, H., Dastidar, P., Loukkola, J., Lehtimaki, T., Korpela, M., Peltola, J., Hietaharju, A. (2005). Cerebral MRI abnormalities and their association with neuropsychiatric manifestations in SLE: A population-based study. Scandinavian Journal of Rheumatology, 34(5), 376–382. doi:10.1080/03009740510026643Google Scholar
The American College of Rheumatology Nomenclature and Case Definitions for Neuropsychiatric Lupus Syndromes. (1999). Arthritis and Rheumatism, 42(4), 599–608. PMID: 10211873. doi:10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.C0;2-FCrossRef3.0.C0;2-F>Google Scholar
Appenzeller, S., Li, L.M., Costallat, L.T., Cendes, F. (2005). Evidence of reversible axonal dysfunction in systemic lupus erythematosus: A proton MRS study. Brain, 128(Pt 12), 2933–2940. doi:10.1093/brain/awh646Google Scholar
Appenzeller, S., Li, L.M., Costallat, L.T., Cendes, F. (2007). Neurometabolic changes in normal white matter may predict appearance of hyperintense lesions in systemic lupus erythematosus. Lupus, 16(12), 963–971. doi:10.1177/0961203307084723CrossRefGoogle ScholarPubMed
Appenzeller, S., Pike, G.B., Clarke, A.E. (2008). Magnetic resonance imaging in the evaluation of central nervous system manifestations in systemic lupus erythematosus. Clinical Reviews in Allergy and Immunology, 34(3), 361–366. doi:10.1007/s12016-007-8060-zCrossRefGoogle ScholarPubMed
Appenzeller, S., Rondina, J.M., Li, L.M., Costallat, L.T.L., Cendes, F. (2005). Cerebral and corpus callosum atrophy in systemic lupus erythematosus. Arthritis and Rheumatism, 52(9), 2783–2789. doi:10.1002/art.21271CrossRefGoogle ScholarPubMed
Appenzeller, S., Vasconcelos Faria, A., Li, L.M., Costallat, L.T., Cendes, F. (2008). Quantitative magnetic resonance imaging analyses and clinical significance of hyperintense white matter lesions in systemic lupus erythematosus patients. Annals of Neurology, 64(6), 635–643. doi:10.1002/ana.21483CrossRefGoogle ScholarPubMed
Axford, J.S., Howe, F.A., Heron, C., Griffiths, J.R. (2001). Sensitivity of quantitative (1)H magnetic resonance spectroscopy of the brain in detecting early neuronal damage in systemic lupus erythematosus. Annals of the Rheumatic Diseases, 60(2), 106–111. doi:10.1136/ard.60.2.106CrossRefGoogle ScholarPubMed
Bosma, G.P., Steens, S.C., Petropoulos, H., Admiraal-Behloul, F., van den Haak, A., Doornbos, J., van Buchem, M.A. (2004). Multisequence magnetic resonance imaging study of neuropsychiatric systemic lupus erythematosus. Arthritis and Rheumatism, 50(10), 3195–3202. doi:10.1002/art.20512CrossRefGoogle ScholarPubMed
Brooks, W.M., Sabet, A., Sibbitt, W.L. Jr., Barker, P.B., van Zijl, P.C., Duyn, J.H., Moonen, C.T. (1997). Neurochemistry of brain lesions determined by spectroscopic imaging in systemic lupus erythematosus. Jouranl of Rheumatology, 24(12), 2323–2329.Google ScholarPubMed
Brooks, W.M., Sibbitt, W.L. Jr., Kornfeld, M., Jung, R.E., Bankhurst, A.D., Roldan, C.A. (2010). The histopathologic associates of neurometabolite abnormalities in fatal neuropsychiatric systemic lupus erythematosus. Arthritis and Rheumatism, 62(7), 2055–2063. doi:10.1002/art.27458Google Scholar
Castellino, G., Govoni, M., Padovan, M., Colamussi, P., Borrelli, M., Trotta, F. (2005). Proton magnetic resonance spectroscopy may predict future brain lesions in SLE patients: A functional multi-imaging approach and follow up. Annals of the Rheumatic Diseases, 64(7), 1022–1027. doi:10.1136/ard.2004.026773CrossRefGoogle ScholarPubMed
Chang, L., Ernst, T., Witt, M.D., Ames, N., Gaiefsky, M., Miller, E. (2002). Relationships among brain metabolites, cognitive function, and viral loads in antiretroviral-naive HIV patients. Neuroimage, 17(3), 1638–1648. doi:10.1006/nimg.2002.1254Google Scholar
Chinn, R.J., Wilkinson, I.D., Hall-Craggs, M.A., Paley, M.N., Shortall, E., Carter, S., Harrison, M.J. (1997). Magnetic resonance imaging of the brain and cerebral proton spectroscopy in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 40(1), 36–46. doi:10.1002/art.1780400107Google Scholar
Davie, C.A., Feinstein, A., Kartsounis, L.D., Barker, G.J., McHugh, N.J., Walport, M.J., Miller, D.H. (1995). Proton magnetic resonance spectroscopy of systemic lupus erythematosus involving the central nervous system. Journal of Neurology, 242(8), 522–528. doi:10.1007/BF00867424CrossRefGoogle ScholarPubMed
Denburg, S.D., Carbotte, R.M., Denburg, J.A. (1987). Cognitive impairment in systemic lupus erythematosus: A neuropsychological study of individual and group deficits. Journal of Clinical and Experimental Neuropsychology, 9(4), 323–339. doi:10.1080/01688638708405054CrossRefGoogle ScholarPubMed
Emmer, B.J., Veer, I.M., Steup-Beekman, G.M., Huizinga, T.W., van der Grond, J., van Buchem, M.A. (2010). Tract-based spatial statistics on diffusion tensor imaging in systemic lupus erythematosus reveals localized involvement of white matter tracts. Arthritis and Rheumatism, 62(12), 3716–3721. doi:10.1002/art.27717CrossRefGoogle ScholarPubMed
Filley, C.M. (2001). The behavioral neurology of white matter. New York: Oxford University Press.CrossRefGoogle Scholar
Filley, C.M. (2009). Exploring white matter microstructure: New insights from diffusion tensor imaging. Neurology, 73(21), 1718–1719. doi:WNL.0b013e3181c2936b [pii] 10.1212/WNL.0b013e3181c2936bGoogle Scholar
Filley, C.M., Kozora, E., Brown, M.S., Miller, D.E., West, S.G., Arciniegas, D.B., Zhang, L. (2009). White matter microstructure and cognition in non-neuropsychiatric systemic lupus erytematosus. Cognitive and Behavioral Neurology, 22(1), 38–44. doi:10.1097/WNN.0b013e31818190d174Google Scholar
Friedman, S.D., Stidley, C.A., Brooks, W.M., Hart, B.L., Sibbitt, W.L. Jr. (1998). Brain injury and neurometabolic abnormalities in systemic lupus erythematosus. Radiology, 209(1), 79–84.Google Scholar
Handa, R., Sahota, P., Kumar, M., Jagannathan, N.R., Bal, C.S., Gulati, M., Wali, J.P. (2003). In vivo proton magnetic resonance spectroscopy (MRS) and single photon emission computerized tomography (SPECT) in systemic lupus erythematosus (SLE). Magnetic Resonance Imaging, 21(9), 1033–1037. doi:10.1016/50730-725x(03)00200-5Google Scholar
Hanly, J.G., Kuznetsova, A., Fisk, J.D. (2007). Psychopathology of lupus and neuroimaging. In Wallace, D.J., HaHn, B.H. (Eds.), Dubois’ Lupus Erythematosus (7th ed.). Philadelphia: Lippincott, Williams & Wilkins.Google Scholar
Hughes, M., Sundgren, P.C., Fan, X., Foerster, B., Nan, B., Welsh, R.C., Gebarski, S. (2007). Diffusion tensor imaging in patients with acute onset of neuropsychiatric systemic lupus erythematosus: A prospective study of apparent diffusion coefficient, fractional anisotropy values, and eigenvalues in different regions of the brain. Acta Radiologica, 48(2), 213–222. doi:772612189 [pii] 10.1080/02841850601105825Google Scholar
Johnson, S.C., Pinkston, J.B., Bigler, E.D., Blatter, D.D. (1996). Corpus callosum morphology in normal controls and traumatic brain injury: Sex differences, mechanisms of injury, and neuropsychological correlates. Neuropsychology, 10(3), 408–415.Google Scholar
Jung, R.E., Caprihan, A., Chavez, R.S., Flores, R.A., Sharrar, J., Qualls, C.R., Roldan, C.A. (2010). Diffusion tensor imaging in neuropsychiatric systemic lupus erythematosus. BMC Neurology, 10, 65. doi:1471-2377-10-65 [pii] 10.1186/1471-2377-10-65CrossRefGoogle ScholarPubMed
Kozora, E. (2008). Neuropsychological functioning in systemic lupus erythematosus. In Morgan, J.E.Ricker, J.H. (Eds.), Textbook of clinical neuropsychology (pp. 636–649). New York: Taylor and Francis.Google Scholar
Kozora, E., Arciniegas, D.B., Filley, C.M., Ellison, M.C., West, S.G., Brown, M.S., Simon, J.H. (2005). Cognition, MRS neurometabolites, and MRI volumetrics in non-neuropsychiatric systemic lupus erythematosus: preliminary data. Cognitive and Behavioral Neurology, 18(3), 159–162.Google Scholar
Kozora, E., Ellison, M.C., West, S. (2004). Reliability and validity of the proposed American College of Rheumatology neuropsychological battery for systemic lupus erythematosus. Arthritis and Rheumatism, 51(5), 810–818. doi:10.1002/art.20692CrossRefGoogle ScholarPubMed
Kozora, E., West, S.G., Kotzin, B.L., Julian, L., Porter, S., Bigler, E. (1998). Magnetic resonance imaging abnormalities and cognitive deficits in systemic lupus erythematosus patients without overt central nervous system disease. Arthritis and Rheumatism, 41(1), 41–47. doi:10.1002/1529-0131(199801)41:1<41::AID-ART6>3.0.C0;2-7Google Scholar
Lim, M.K., Suh, C.H., Kim, H.J., Cho, Y.K., Choi, S.H., Kang, J.H., Lee, J.H. (2000). Systemic lupus erythematosus: Brain MR imaging and single-voxel hydrogen 1 MR spectroscopy. Radiology, 217(1), 43–49.Google Scholar
Mortilla, M., Ermini, M., Nistri, M., Dal Pozzo, G., Falcini, F. (2003). Brain study using magnetic resonance imaging and proton MR spectroscopy in pediatric onset systemic lupus erythematosus. Clinincal and Experimental Rheumatology, 21(1), 129–135.Google ScholarPubMed
Rovaris, M., Riccitelli, G., Judica, E., Possa, F., Caputo, D., Ghezzi, A., Filippi, M. (2008). Cognitive impairment and structural brain damage in benign multiple sclerosis. Neurology, 71(19), 1521–1526. doi:01.wnl.0000319694.14251.95 [pii] 10.1212/01.wnl.0000319694.14251.95Google Scholar
Sabet, A., Sibbitt, W.L., Stidley, C.A., Danska, J., Brooks, W.M. (1998). Neurometabolite markers of cerebral injury in the antiphospholipid antibody syndrome of systemic lupus erythematosus. Stroke, 29, 2254–2260.Google Scholar
Shucard, J.L., Gaines, J.J., Ambrus, J. Jr., Shucard, D.W. (2007). C-reactive protein and cognitive deficits in systemic lupus erythematosus. Cognitive and Behavioral Neurology, 20(1), 31–37. doi:10.1097/WNN.0b013e31802e3b9aGoogle Scholar
Sibbitt, W.L. Jr., Haseler, L.J., Griffey, R.R., Friedman, S.D., Brooks, W.M. (1997). Neurometabolism of active neuropsychiatric lupus determined with proton MR spectroscopy. American Journal of Neuroradiology, 18(7), 1271–1277.Google ScholarPubMed
Sundgren, P.C., Jennings, J., Attwood, J.T., Nan, B., Gebarski, S., McCune, W.J., Maly, P. (2005). MRI and 2D-CSI MR spectroscopy of the brain in the evaluation of patients with acute onset of neuropsychiatric systemic lupus erythematosus. Neuroradiology, 47(8), 576–585. doi:10.1007/s00234-005-1371-yGoogle Scholar
Ulug, A.M., Vo, A., Kozora, E., Ramos, G.G., Vega, J., Zimmerman, M., Lockshin, M.D. (2010). fMRI in systemic lupus erythematosus and antiphospholipid syndrome. Proceedings of the International Society for Magnetic Resonance in Medicine, 18, 4466A.Google Scholar
Zhang, L., Harrison, M., Heier, L.A., Zimmerman, R.D., Ravdin, L., Lockshin, M., Ulug, A.M. (2007). Diffusion changes in patients with systemic lupus erythematosus. Magnetic Resonance Imaging, 25(3), 399–405. doi:10.1016/j.mri.2006.09.037Google Scholar