Assessment of white matter injury in systemic lupus erythematosus with cognitive dysfunction by diffusion tensor imaging

Abstract

Objective To investigate the white matter injury in patients with systemic lupus erythematosus (SLE) combined with cognitive dysfunction by diffusion tensor imaging (DTI). Methods The Montreal cognitive assessment, conventional magnetic resonance imaging (MRI) and DTI were performed in 11 SLE patients with cognitive dysfunction (CDF), 11 SLE patients without cognitive dysfunction (non-CDF) and 10 health controls. Local gray differences among three groups were compared by SPM5 software and voxel-based analysis. Results In conventional MRI, abnormal lesions were detected in 3 CDF patients. In DTI, compared to non-CDF group, CDF patients showed significantly increased apparent diffusion coefficient (ADC) values in right precuneus and brodmann area 6, 21 (P<0.01). No difference of fractional anisotropy (FA) was found between these two groups. Compared to health controls, CDF patients showed significantly decreased FA values in right parahippocampa gyrus, cerebellar tonsil and pons (P<0.01), and increased ADC values in right superior frontal gyrus, cuneus, middle temporal gyrus, insula, brodmann area (13, 20, 21, 27, 30, 47), and left middle frontal gyrus, brodmann area 10, cingulate gyrus and corpus callosum (P<0.01). Compared to health controls, non-CDF patients showed significantly increased ADC values in right parahippocampa gyrus, superior frontal gyrus, brodmann area (10, 25), left middle temporal gyrus, middle occipital gyrus, brodmann area (3, 13, 19, 25), bilateral insula and corpus callosum (P<0.01), and no difference of FA. Conclusions DTI is more sensitive to detect white matter impairment of cognitive dysfunction in SLE patients than conventional MRI. Key words: Diffusion magnetic resonance imaging; Lupus erythematosus, systemic/CO/RA; Cognition disorders/CO/RA