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Enlarged perivascular spaces are associated with the disease activity in systemic lupus erythematosus

Mari Miyata1, Shingo Kakeda2, Shigeru Iwata3

  • 1Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.

Scientific Reports
|October 5, 2017
PubMed

Insights

Enlarged perivascular spaces in the centrum semiovale (CS-EPVS) are linked to disease severity in systemic lupus erythematosus (SLE). This finding suggests CS-EPVS may indicate white matter changes due to inflammation in SLE patients.

Area of Science:

  • Neurology
  • Rheumatology
  • Radiology

Background:

  • Systemic lupus erythematosus (SLE) can affect the brain, but the relationship between specific MRI abnormalities and disease activity requires further investigation.
  • Enlarged perivascular spaces (EPVS) are a common finding on brain MRI, and their association with SLE disease activity is not well-established.

Purpose of the Study:

  • To investigate the association between brain MRI abnormalities, particularly enlarged perivascular spaces (EPVS), and disease activity in patients with systemic lupus erythematosus (SLE).
  • To identify specific imaging characteristics and clinical factors associated with SLE disease severity.

Main Methods:

  • One hundred and thirty SLE patients were assessed using brain MRI, focusing on centrum semiovale EPVS (CS-EPVS), basal ganglia EPVS, white matter hyperintensity (WMH), and brain atrophy.
  • Disease activity was quantified using the SLEDAI and BILAG scores.
  • Univariate and multivariate logistic regression analyses were employed to determine associations between clinical and imaging findings and SLE disease activity.

Main Results:

  • High CS-EPVS was the sole factor independently associated with increased SLEDAI and BILAG scores.
  • The odds ratio for SLEDAI severity was 5.77 (95% CI 2.21-15.00, p < 0.001) and for BILAG score was 2.64 (95% CI 1.03-6.74, p = 0.042).
  • No exclusion criteria were applied for patients with brain atrophy or mild WMH on T2WI.

Conclusions:

  • Centrum semiovale EPVS in SLE patients is significantly associated with systemic disease activity.
  • CS-EPVS may serve as an imaging biomarker reflecting white matter alterations secondary to inflammatory processes in SLE.
  • Further research into the role of CS-EPVS in SLE pathogenesis and neurological manifestations is warranted.

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