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Cerebral blood flow variations in CNS lupus
M J Kushner1, M Tobin, F Fazekas
1Department of Neurology, University of Pennsylvania Medical Center, Philadelphia 19104.
Neurology
|January 1, 1990
Summary
Cerebral blood flow (CBF) normalizes during remission in systemic lupus erythematosus patients. However, CBF significantly decreases during central nervous system (CNS) flare-ups, with severity varying by neurological symptoms.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Systemic lupus erythematosus (SLE) can present with diverse neurological manifestations.
- Understanding the underlying cerebral hemodynamics in SLE neurological involvement is crucial for diagnosis and management.
Observation:
- Cerebral blood flow (CBF) was assessed using xenon-133 in patients with SLE and various neurological symptoms.
- Measurements were taken during both central nervous system (CNS) remission and exacerbation phases.
Findings:
- CBF remained normal during CNS remissions, irrespective of the specific neurological symptoms.
- CBF was significantly reduced during CNS exacerbations.
- The degree of CBF reduction correlated with the severity of neurological manifestations, being most pronounced in encephalopathy and psychosis.
Implications:
- CBF patterns can serve as a biomarker for CNS activity in SLE.
- Monitoring CBF may aid in assessing disease activity and treatment response in neuropsychiatric SLE.
- SPECT imaging may reveal perfusion defects that resolve with clinical improvement, even without overt ischemia.