Cerebral changes in SLE with or without antiphospholipid syndrome. a case-control MRI study

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.