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Hippocampal atrophy in systemic lupus erythematosus
S Appenzeller1, A D Carnevalle, L M Li
1Department of Rheumatology, University of Campinas, São Paulo, Brazil.
Annals of the Rheumatic Diseases
|January 28, 2006
Summary
Systemic lupus erythematosus (SLE) patients show significant hippocampal atrophy, which worsens over time. This atrophy is linked to disease duration, corticosteroid use, and central nervous system (CNS) events.
Area of Science:
- Neuroimaging
- Rheumatology
- Neurology
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease with potential neurological complications.
- Hippocampal atrophy is a recognized marker of neurodegeneration, but its prevalence and progression in SLE are not fully understood.
Purpose of the Study:
- To investigate the frequency and progression of hippocampal atrophy in patients with SLE.
- To identify clinical, laboratory, and treatment factors associated with hippocampal atrophy in SLE.
Main Methods:
- 150 SLE patients and 40 healthy controls underwent clinical, laboratory, and neurological evaluations.
- Magnetic resonance imaging (MRI) was used for manual volumetric measurements of hippocampal regions.
- Atrophy was defined as hippocampal volumes below 2 standard deviations from control means.
Main Results:
- SLE patients exhibited significantly smaller hippocampal volumes at baseline compared to controls (p<0.001).
- A significant progression of hippocampal volume reduction was observed in SLE patients during follow-up MRI (p<0.001).
- Hippocampal atrophy was prevalent in 43.9% at baseline and 66.7% at follow-up, associated with disease duration, corticosteroid dose, and CNS manifestations.
Conclusions:
- Longer disease duration, cumulative corticosteroid dose, and a history of CNS events are associated with hippocampal atrophy in SLE.
- Progression of hippocampal atrophy is linked to corticosteroid dose and the number of CNS events.
- Cognitive impairment in SLE patients correlated with more severe hippocampal atrophy.
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