Distribution of white matter hyperintensity in SSc patients: a monocenter, cross-sectional magnetic resonance imaging...

Systemic Sclerosis (SSc) is a systemic autoimmunity White matter hyperintensities (WMH) are typical indicators of cerebral small vessel disease, classified into periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH). Our study aims to investigate the quantitative characteristics and distribution patterns of WMH between SSc patients, healthy population and between different SSc subtypes using magnetic resonance (MR) imaging. Whether cognitive dysfunction and anxiety/depression are associated with white matter alterations in the SSc were also explored.

SSc patients and healthy controls (HCs) were recruited and brain MR was performed. Clinical information, laboratory tests and scales were collected. Whole white matter and WMH volume were segmented and quantified. Independent t test, Mann-Whitney U test and the χ2 test were applied to determine the differences between groups. Clinical information and its association with WMH were investigated by logistic regression.

Eighty-four SSc patients and 30 HCs were included. WMH was more prevalent and a significantly greater proportion of DWMH [2.28 × 10-4 (IQR 0.35 × 10-4, 9.68 × 10-4) vs 0.91 × 10-4 (IQR 0,3.31 × 10-4), P= 0.0339] was notified in SSc patients. Distinct WMH distribution patterns were noted between SSc subtypes, that PVH/WMH proportion corrected residual value was larger in dcSSc patients [0.06 (IQR -0.15 - 0.17) vs -0.16 (IQR -0.30-0.13), P= 0.0346]. No correlations were found between scales results and WMH volume ratios.

These findings suggested that SSc patients are more likely to acquire WMH, particularly in the deep white matter regions. Comparisons also lend support to the hypothesis that the distribution patterns of WMH between dcSSc and lcSSc patients might be distinct.