RESEARCH - Hippocampal atrophy in SLE

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Published Online First: 26 January 2006. doi:10.1136/ard.2005.049486

ls of the Rheumatic Diseases 2006;65:1585-1589

© 2006 by BMJ Publishing Group Ltd & European League Against Rheumatism

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EXTENDED REPORT

Hippocampal atrophy in systemic lupus erythematosus

S Appenzeller1, A D Carnevalle3, L M Li2, L T L Costallat1 and F Cendes2

1 Department of Rheumatology, University of Campinas, São o, Brazil

2 Department of Neurology, University of Campinas, São o, Brazil

3 Neuroimaging Laboratory, University of Campinas, São o, Brazil

Correspondence to:

F Cendes

Department of Neurology, University of Campinas-UNICAMP, Cidade

Universitária, Campinas, São o CEP 13083-970, Brazil; fcendes@...

Objectives: To determine the frequency and progression of hippocampal

atrophy in systemic lupus erythematosus (SLE) and the clinical, laboratory

and treatment features associated with its occurrence.

Methods: 150 patients with SLE and 40 healthy volunteers were enrolled in

our study. A complete clinical, laboratory and neurological evaluation was

performed. Magnetic resonance imaging was carried out using a 2T scanner

(Elscint Prestige) and coronal T1-weighted images were used for manual

volumetric measurements. Atrophy was defined as values <2 standard

deviations from the means of controls.

Results: At entry into the study, the mean right and left hippocampal

volumes of patients were significantly smaller than the hippocampal volumes

of controls (p<0.001). After the follow-up magnetic resonance imaging, a

significant progression of reduction in right and left hippocampal volumes

in patients was observed (p<0.001). At entry, atrophy was identified in

43.9% and at follow-up in 66.7% of patients with SLE. Hippocampal atrophy

was related to disease duration (p<0.001) total corticosteroid dose (p =

0.01) and history of central nervous system (CNS) manifestations (p = 0.01).

Progression of atrophy was associated with cumulative corticosteroid dose (p

= 0.01) and number of CNS events (p = 0.01). Patients with cognitive

impairment had more severe hippocampal atrophy than those without.

Conclusion: Disease duration, total corticosteroid dose and greater number

of CNS manifestations were associated with hippocampal atrophy in patients

with SLE. A significant progression of hippocampal atrophy related to total

corticosteroid dose and number of CNS events was observed. Further studies

are necessary to confirm these findings.

http://ard.bmj.com/cgi/content/abstract/65/12/1585

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