Temporal and spatial changes in cerebral blood flow in neuropsychiatric systemic lupus erythematosus: a subtraction brain spect study
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2021
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This study was addressed to evaluate the temporal and spatial changes in regional cerebral
blood flow (rCBF) of patients with neuropsychiatric systemic lupus erythematosus
(NPSLE). Our objective was to correlate the subtracted SPECT coregistered to MRI features
(SISCOM) with demographic, clinical and laboratory findings to shed light upon
the pathophysiological evolution of the NPSLE. Twenty-six NPSLE patients with MRI and
pre- and post-treatment brain SPECT with [99mTc]Tc-ECD. SISCOM features were categorized
as improvement, worsening, activation and/or deactivation of rCBF findings.
Patients mean age of 43.19 years and 65.38% white were evaluated. The patients mean
age at onset of SLE was 26.05 and 42.29 for NPSLE. The mean time between the onset
of SLE and first NPSLE symptoms was 05.57 years. The disease has already been initiated
as NPSLE in 4 patients. The SLEDAI average score was 31.69 and the SLICC/ACR-DI
score was 06.96. The patients underwent an average of 09.23 cyclophosphamide. The
SISCOM findings showed functional and pathological states on different brain regions.
The rCBF changes were not associated with index scores. There was, however, a trend
towards an association between lower SLEDAI scores with improvement and higher
SLEDAI with worsening in SISCOM, Also a trend of association between lower SLICC
score with improvement, and higher SLICC with worsening. The female gender was
predictive of activation and worsening, separately, and deactivation and worsening
in a set. Non-white patients were predictive of worsening. The seizure was predictive
of deactivation separately, and deactivation and worsening in a set. Finally, normal C3
was a predictor of improvement. The present study showed dynamic brain changes
in NPSLE patients. SISCOM technique showed improved rCBF in some brain areas, and
worsening, activation and deactivation in others. There were associations between
rCBF changes and gender, skin colour and complement C3 and association trends with
SLEDAI and SLICC scores.
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Systemic lupus erythematosus, SISCOM, Neuropsychiatric form, Brain SPECT
Citação
TREVISAN, Ana Carolina et al. Temporal and spatial changes in cerebral blood flow in neuropsychiatric systemic lupus erythematosus: a subtraction brain spect study. European Journal of Hybrid Imaging, London, v. 5, n. 1, p. 1-13, 2021. DOI: 10.1186/s41824-021-00112-3. Disponível em: https://pubmed.ncbi.nlm.nih.gov/34734310/. Acesso em: 19 abr. 2023.