RESEARCH - Cognitive function and 99mTc-ECD brain SPECT are significantly correlated in patients with primary Sjogren's syndrome

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Ann Rheum Dis. Published Online First: 21 January 2009.

doi:10.1136/ard.2008.090811

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Extended Report

Cognitive function and 99mTc–ECD brain SPECT are significantly

correlated in patients with primary Sjögren's syndrome: a case–control

study

V Le Guern 1*, C Belin 2, C Henegar 1, C Moroni 2, D Maillet 2, C

Lacau 2, JL Dumas 2, N Caillat-Vigneron 2 and L Guillevin 1

1 Hospital COCHIN, France

2 Hospital Avicenne, France

Abstract

Objectives: To assess subclinical central nervous system (CNS)

involvement in primary Sjögren's syndrome (pSS), by comparing standard

brain magnetic resonance imaging (MRI), in-depth neuropsychological

testing and 99mTc–ECD brain SPECT of pSS patients to matched controls.

Methods: We prospectively investigated 10 women (<55 years old), with

pSS defined using European–American criteria, presence of anti-SSA

and/or anti-SSB antibodies and no history of neurological involvement,

and compared them to 10 age- and sex-matched controls. All subjects

underwent, within 1 month, brain MRI, neuropsychological testing,

including overall evaluation and focal cognitive function assessment,

and 99mTc–ECD brain SPECT.

Results: 99mTc–ECD brain-SPECT abnormalities were significantly more

frequent in pSS patients than controls (p<0.05). Cognitive

dysfunctions, mainly expressed as executive and visuospatial

disorders, were also significantly more frequent in pSS patients

(p<0.01). Notably, between-group comparisons enabled a significant

correlation to be established between neuropsychological assessment

and 99mTc–ECD brain-SPECT abnormalities in pSS patients (rs = 0.49,

p<0.01). MRI abnormalities in patients and controls did not differ

significantly.

Conclusion: Neuropsychological testing and 99mTc–ECD brain SPECT seem

to represent the most sensitive tools to detect subclinical CNS

dysfunction in pSS. The strong correlation between cortical

hypoperfusion in 99mTc–ECD brain SPECT and cognitive dysfunction

suggests an organic etiology of CNS dysfunction in pSS. These data

should be confirmed in a larger study.

http://ard.bmj.com/cgi/content/abstract/ard.2008.090811v1?papetoc

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