Clinical Factors Associated with Brain Volume Reduction in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations

Shuang Liu; Yuqi Cheng; Yueyin Zhao; Hongjun Yu; Aiyun Lai; Zhaoping Lv; Xiufeng Xu; Chunrong Luo; Baoci Shan; Lin Xu; Jian Xu

doi:10.3389/fpsyt.2018.00008

Clinical Factors Associated with Brain Volume Reduction in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations

Front Psychiatry. 2018 Feb 1:9:8. doi: 10.3389/fpsyt.2018.00008. eCollection 2018.

Authors

Shuang Liu¹, Yuqi Cheng², Yueyin Zhao¹, Hongjun Yu³, Aiyun Lai¹, Zhaoping Lv¹, Xiufeng Xu², Chunrong Luo³, Baoci Shan⁴, Lin Xu⁵, Jian Xu¹

Affiliations

¹ Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
² Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China.
³ Magnetic Resonance Imaging Center, The First Hospital of Kunming, Kunming, China.
⁴ Key Laboratory of Nuclear Analysis, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China.
⁵ Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.

Abstract

The aim of the study was to find structural brain changes in systemic lupus erythematosus patients without major neuropsychiatric manifestations [non-neuropsychiatric systemic lupus erythematosus (non-NPSLE)] using quantitative magnetic resonance imaging (MRI) and possible associations with clinical characteristics. 89 non-NPSLE patients with normal conventional MRI and 84 healthy controls (HCs) were recruited. The whole brain gray matter volume (GMV) and white matter volume (WMV) were calculated for each individual. We found obvious GMV and WMV reduction in the systemic lupus erythematosus (SLE) group compared with HCs. Female patients showed significant reduction of GMV and WMV compared with male patients. Patients treated with immunosuppressive agents (ISA) showed less WMV reduction than those without. Cognitive impairment was the most common subclinical neuropsychiatric manifestation and had a prevalence of 46.1%. Association between WMV reduction with cognitive impairment was found. Thus, we concluded that structural brain atrophy could happen even before occurrence of obvious neuropsychiatric signs and symptoms and was associated with subclinical symptoms such as cognitive impairment. ISA treatment might have a protective effect on the brain atrophy. Early treatment might prevent the progressive damage to the brain. More studies are needed to fully understand the complicated underlying mechanisms of brain atrophy in SLE.

Keywords: brain volume reduction; cognitive impairment; immunosuppressive agents; quantitative magnetic resonance imaging; systemic lupus erythematosus.