Zimmermann Nicolle, Corrêa Diogo Goulart, Kubo Tadeu Almodovar, Netto Tania Maria, Pereira Denis Batista, Fonseca Rochele Paz, Gasparetto Emerson Leandro
Department of Radiology, Federal University of Rio de Janeiro, Brigadeiro Trompowsky Avenue, Clementino Fraga Filho University Hospital, Room SSN29, 21941-590, Rio de Janeiro, Brazil.
Department of Medical Physics, Diagnósticos da America S.A., DASA, 4666 das Américas Avenue, Barra da Tijuca, 22640-102, Rio de Janeiro, Brazil.
Clin Neuroradiol. 2017 Mar;27(1):23-29. doi: 10.1007/s00062-015-0397-8. Epub 2015 May 13.
This study investigated differences in subcortical brain volumes of SLE patients with cognitive deficits (SLE-CD) and SLE patients with normal cognitive performance (SLE-CN), regardless of the presence of other neuropsychiatric symptoms.
We studied 40 patients divided into two-matched groups (SLE-CD n = 20; SLE-CN n = 20), with age ranging from 21 to 63 years old (100 % female) and 14.73 ± 10.18 years of diagnosis. Magnetic resonance imaging exams were performed on a 1.5 T scanner. A neuropsychological flexible battery was applied individually, including reasoning/problem-solving, praxis, episodic and working memory, processing speed, language/fluency, executive functions (inhibition and flexibility), and sustained attention. Z score ≤ - 2.0 in any dimension was considered as a cut-off for being considered to possess cognitive deficits. One-way analyses of covariance (ANCOVA) were performed to compare the brain structure volumes between groups. The analyses were controlled for the effects of lupus-related neuropsychiatric disorders.
SLE patients with cognitive deficits had significantly smaller volumes in the left hippocampus, amygdala, and the right hippocampus than SLE patients without cognitive deficits.
SLE patients with cognitive deficits appeared to have reduced temporal lobe structures when compared with SLE without cognitive deficits. These results corroborate a systems vulnerability model that investigated temporal lobe vulnerability during normal aging and in other neurological disorders.
本研究调查了存在认知缺陷的系统性红斑狼疮患者（SLE-CD）和认知功能正常的系统性红斑狼疮患者（SLE-CN）的皮质下脑容量差异，而不考虑其他神经精神症状的存在。
我们研究了40例患者，分为两个匹配组（SLE-CD组n = 20；SLE-CN组n = 20），年龄在21至63岁之间（100%为女性），诊断时间为14.73±10.18年。在1.5T扫描仪上进行磁共振成像检查。单独应用神经心理学灵活测试组，包括推理/解决问题、实践能力、情景记忆和工作记忆、处理速度、语言/流畅性、执行功能（抑制和灵活性）以及持续注意力。任何维度的Z分数≤ -2.0被视为存在认知缺陷的临界值。进行单因素协方差分析（ANCOVA）以比较两组之间的脑结构体积。分析中控制了狼疮相关神经精神障碍的影响。
与无认知缺陷的SLE患者相比，存在认知缺陷的SLE患者左海马、杏仁核和右海马的体积明显更小。
与无认知缺陷 的SLE患者相比，存在认知缺陷的SLE患者似乎颞叶结构减少。这些结果证实了一个系统易损性模型，该模型研究了正常衰老和其他神经系统疾病期间的颞叶易损性。
