Magnetic resonance imaging abnormalities and cognitive deficits in systemic lupus erythematosus patients without overt central nervous system disease

To investigate cerebral magnetic resonance imaging (MRI) abnormalities in relation to cognitive functioning in systemic lupus erythematosus (SLE) patients without a history of central nervous system (CNS) disease.

Ventricle-to-brain ratios (VBRs) and the total number of white matter hyperintensities (WMHIs) were computed in 20 female patients with non-CNS SLE using established MRI computer-generated quantification procedures. Comprehensive neuropsychological test scores across 8 domains were also obtained.

A mean VBR of 2.83% (SD = 0.7) occurred in the non-CNS SLE patients compared with a VBR of 1.36% in a normative sample. The average number of WMHIs was 4.95 (SD = 6.0). Using a combined rating scale (VBR > 2.25%, WMHIs > 5), 7 of 20 MRI scans (35%) were classified as abnormal. Increased VBRs and larger numbers of WMHIs showed a trend association with longer duration of SLE. Thirty-five percent of the non-CNS SLE patients demonstrated neuropsychological deficits. No significant correlations were found between the VBR, total WMHIs, and cognitive scores. Comparisons of cognitively impaired and nonimpaired patients with non-CNS SLE revealed no significant differences across clinical characteristics or MRI values.

Quantified MRI analyses indicated atypical brain structure and an increased number of WMHIs in a subset of non-CNS SLE patients. However, these MRI abnormalities were not associated with functional abnormalities determined by comprehensive neuropsychological testing. Therefore, MRI analyses are not likely to provide additional clinical information on cognitively impaired SLE patients who have no other evidence of CNS involvement.