Structural and atrophic changes in the brain in patients with systemic lupus erythematosus
Summary. Abstract. Systemic lupus erythematosus (SLE) is a chronic disease of autoimmune-inflammatory origin occurring with the involvement of many organ systems. One of the typical manifestations is neuropsychiatric SLE — a complex of neurological and mental disorders that arise in patients with this disease. Aim: to study the characteristics of morphological disorders of the brain in patients with SLE. Object and research methods. The object of the study was radiological findings, in particular atrophic phenomena, of the brain in patients with SLE. All patients underwent neuroimaging examinations — magnetic resonance imaging (MRI) of the brain on an apparatus with a field induction of 1.5 T. This examination included a visual qualitative assessment of tomograms in order to identify structural abnormalities. To assess atrophic phenomena, the morphometric indices were calculated, which represent the relative values of the volume of the brain parenchyma in a particular area, — FFR, SFR, BFR and BCR. Results. During MRI, only one patient in group 2 was found to have changes, namely the expansion of cerebrospinal fluid spaces, while in 34 (62.9%) patients of the main group, these disorders were identified (p=0.002). Also in 7 (12.9%) patients in group 1, post-stroke cysts were found, leukoaraiosis (p=0.006) in 25 (46.3%), and demyelinating processes in 8 (14.8%). Average levels of morphometric indices of brain atrophy in examined patients with SLE ranged from 0.055 (0.034; 0.061) — FFR to 0.304 (0.282; 0.318) — BFR. For all indices of brain atrophy, statistically significant differences between the study groups were determined according to statistically significantly higher (p<0.001) mean values in patients of group 1, compared to group 2. Conclusions. In the structure of morphological changes detected on MRI of the brain in patients with SLE, nonspecific findings dominate: atrophic phenomena, leukoaraiosis and expansion of cerebrospinal fluid spaces. The prevalence of radiological findings on MRI of the brain in patients with SLE with neurological manifestations is significantly higher than in patients with SLE without neurological manifestations. The severity of cortex and subcortical atrophy in patients with neuropsychiatric SLE is significantly higher than in patients without neurological manifestations in all morphometric indices.
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