Hippocampal Atrophy in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations.

Shuang Liu,Zhaoping Lv,Yueyin Zhao,Lin Xu,Aiyun Lai,Xiufeng Xu,Chunrong Luo,Yuqi Cheng,Jian Xu,Zhongqi Xie,Xiangyu Wang,Baoci Shan,Hongjun Yu,Bibhuti Upreti

doi:10.1155/2020/2943848

Abstract

This study was conducted to explore hippocampal structural changes and their possible associations with clinical characteristics, emotional status, and treatment regimens in patients with systemic lupus erythematosus (SLE) without major neuropsychiatric manifestations (non-NPSLE). Eighty-five non-NPSLE patients with normal conventional magnetic resonance imaging (MRI) and seventy-seven matched healthy control (HC) subjects were recruited. All participants underwent the standard high-resolution volumetric MRI. The bilateral hippocampal volume (HIPV) and hippocampal density (HIPD) were calculated, respectively, for each participant. We found that the bilateral HIPV and HIPD of the SLE patient group were significantly less than those of the HC group. The bilateral HIPV of female patients were significantly less than those of male patients. The SLE disease activity index (SLEDAI) was negatively correlated with the bilateral HIPV and the right HIPD. Urine protein quantity was negatively correlated with the bilateral HIPV and HIPD. Hydroxychloroquine (HCQ) showed a protective effect on right HIPV. In conclusion, we found that the early hippocampal atrophy could occur before obvious neuropsychiatric manifestations and might be associated with SLE disease activity and organ damages. Early detection and intervention of hippocampal damage might prevent the progression to NPSLE. More studies are needed to fully understand the underlying mechanisms of hippocampal atrophy in SLE.

Highlights

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement
We have found that the white matter volume (WMV) of the non-neuropsychiatric SLE (NPSLE) patient group was significantly less than that of healthy control (HC) group and that immunosuppressive agents (ISA) treatment might have a protective effect on WMV [7]
In another study, we found that specific autoantibodies, such as anti-cardiolipin antibodies, might contribute to the reduction of grey matter density (GMD) and white matter density (WMD) in non-NPSLE patients

Summary

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement. It is characterized by high titers of various serum antibodies targeting nuclear or cytoplasmic antigens. Glucocorticoids (GC) and immunosuppressive agents (ISA) are used to help patients reach the target of remission or low disease activity. The central nervous system (CNS) is commonly involved in SLE [2, 3]. Brain atrophy has been detected in SLE patients using several neuroimaging techniques. It is often associated with clinical manifestations in SLE patients and sometimes even in patients without obvious CNS signs and symptoms [4, 5]. Hippocampal atrophy was found in SLE patients

Methods

Results

Conclusion