Related Experiment Video
Updated: Jul 8, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebral changes in SLE with or without antiphospholipid syndrome. a case-control MRI study
Sergio I Valdés-Ferrer1, Felipe Vega, Carlos Cantú-Brito
1Department of Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. sivaldes@quetzal.innsz.mx
Background:
To determine and characterize the prevalence of cerebral changes on MRI in patients with antiphospholipid syndrome (APLS) within systemic lupus erythematosus (SLE).
Methods:
Seventy-one patients with SLE were prospectively studied with brain MRI: 32 with definite APLS and 39 without. Atrophy, ventricular enlargement, leukoaraiosis, interuncal distance, Evans' index, infarcts, and white matter hyperintensities (WMH) were analyzed. Demographic data, treatment, and SLE activity were analyzed.
Results:
Groups were similar in age (32.4 vs. 32.8 years old; P= non-significant [NS]), and gender. Duration of disease was longer in patients with APLS (87.3 vs. 55.4 months; P= .064). Cortical atrophy was common in both groups (68.7% vs. 89.7%; P= NS). Leukoaraiosis was present in only 3 patients (9.4%; P= .08), all in the APLS group. WMH were found in more than 40% of the patients from both groups. Infarcts (21.9% vs. 2.6%; P= .019) and infarcts plus WHM (12.5% vs. 0; P= .037) were more common in patients with APLS.
Conclusions:
Although a higher prevalence of neurological involvement in SLE has been reported in APLS patients, we found gross brain changes to be similar between groups. Strokes and leukoaraiosis were more common in the APLS group, consistent with the idea of an APLS-induced prothrombotic state.
Insights
Cerebral MRI findings in systemic lupus erythematosus (SLE) patients with antiphospholipid syndrome (APLS) showed similar gross brain changes. However, strokes and leukoaraiosis were more prevalent in APLS patients, suggesting a prothrombotic state.
Area of Science:
- Neurology
- Radiology
- Rheumatology
Background:
- Antiphospholipid syndrome (APLS) is associated with increased neurological complications in systemic lupus erythematosus (SLE).
- Characterizing cerebral changes on MRI in SLE patients with and without APLS is crucial for understanding disease mechanisms.
Purpose of the Study:
- To determine and characterize the prevalence of cerebral changes on MRI in patients with antiphospholipid syndrome (APLS) within systemic lupus erythematosus (SLE).
Main Methods:
- Prospective brain MRI study of 71 SLE patients: 32 with APLS and 39 without.
- Analysis included atrophy, ventricular enlargement, leukoaraiosis, infarcts, and white matter hyperintensities (WMH).
- Demographic data, treatment, and SLE activity were also analyzed.
Main Results:
- Groups were similar in age and gender; disease duration was longer in APLS patients.
- Cortical atrophy and WMH were common in both groups.
- Strokes and leukoaraiosis were significantly more frequent in patients with APLS.
Conclusions:
- Gross brain changes were similar between SLE patients with and without APLS.
- Increased prevalence of strokes and leukoaraiosis in APLS patients supports an APLS-induced prothrombotic state.
- MRI findings highlight the importance of considering APLS in SLE patients with neurological events.
