系统性红斑狼疮患者的脑形态和皮质厚度变化：神经、精神和非神经精神表现之间的差异。
Brain morphology and cortical thickness variations in systemic lupus erythematosus patients: Differences among neurological, psychiatric, and nonneuropsychiatric manifestations.
作者信息
Zimmermann Nicolle, Goulart Corrêa Diogo, Tukamoto Gustavo, Netto Tania, Batista Pereira Denis, Paz Fonseca Rochele, Gasparetto Emerson Leandro
机构信息
Federal University of Rio de Janeiro, Department of Radiology, Rio de Janeiro, Brazil.
Clínica de Diagnóstico Por Imagem, Multi-imagem, DASA, Rio de Janeiro, Brazil.
出版信息
J Magn Reson Imaging. 2017 Jul;46(1):150-158. doi: 10.1002/jmri.25538. Epub 2016 Nov 8.
PURPOSE
To determine whether systemic lupus erythematosus (SLE) affecting subcortical white matter volumes, deep gray matter volumes, and cortical thickness differ between groups of SLE patients with psychiatric (P-SLE), neurological (N-SLE), or nonneuropsychiatric (non-NPSLE) presentations.
MATERIALS AND METHODS
Sixty-seven participants were divided into three groups (P-SLE [n = 19], N-SLE [n = 12], and non-NPSLE [n = 36]) and examined with a 1.5T MRI scanner. The images were segmented in FreeSurfer software into volumetric and cortical thickness measures using T 3D magnetization prepared rapid gradient echo-weighted imaging. For comparative analyses of volume, multivariate analyses of covariance (MANCOVA) were applied followed by Bonferroni post-hoc tests, with age as a covariate. For cortical thickness analyses, the groups were compared with the Query Design Estimate Contrast tool adjusted for age.
RESULTS
Globus pallidus volumes in both left (P ≤ 0.01) and right (P ≤ 0.05) hemispheres were larger in the N-SLE group than in the non-NPSLE group, and the left GP volume was greater in the N-SLE group than in the P-SLE group (P ≤ 0.05) (MANCOVA, post-hoc Bonferroni). The P-SLE group presented with thinning of cortical areas relative to the N-SLE (predominantly in the left parietal and right frontal and parietal regions) (P ≤ 0.05) and non-NPSLE (predominantly in parietal and occipital regions) (P ≤ 0.05) groups, whereas the N-SLE group presented with thickening of cortical areas (mostly right frontal and left parietal regions) relative to the non-NPSLE (P ≤ 0.05) and P-SLE groups.
CONCLUSION
N-SLE patients had greater local volumes and cortical thicknesses than the other two groups, whereas P-SLE patients presented with decreased volumes and cortical thinning. These findings provide evidence of distinct neuroanatomical abnormalities in neurological versus psychiatric manifestations of SLE.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:150-158.
目的
确定患有精神性（P-SLE）、神经性（N-SLE）或非神经精神性（非NPSLE）表现的系统性红斑狼疮（SLE）患者组之间，SLE对皮质下白质体积、深部灰质体积和皮质厚度的影响是否存在差异。
材料与方法
67名参与者被分为三组（P-SLE组[n = 19]、N-SLE组[n = 12]和非NPSLE组[n = 36]），并使用1.5T MRI扫描仪进行检查。使用T 3D磁化准备快速梯度回波加权成像，在FreeSurfer软件中将图像分割为体积和皮质厚度测量值。对于体积的比较分析，应用多变量协方差分析（MANCOVA），随后进行Bonferroni事后检验，将年龄作为协变量。对于皮质厚度分析，使用针对年龄调整的查询设计估计对比工具对各组进行比较。
结果
N-SLE组左（P≤0.01）、右（P≤0.05）半球苍白球体积均大于非NPSLE组，且N-SLE组左苍白球体积大于P-SLE组（P≤0.05）（MANCOVA，事后Bonferroni检验）。相对于N-SLE组（主要在左顶叶、右额叶和顶叶区域）（P≤0.05）和非NPSLE组（主要在顶叶和枕叶区域）（P≤0.05），P-SLE组出现皮质区域变薄；而相对于非NPSLE组（P≤0.05）和P-SLE组，N-SLE组出现皮质区域增厚（主要在右额叶和左顶叶区域）。
结论
N-SLE患者的局部体积和皮质厚度大于其他两组，而P-SLE患者的体积减小且皮质变薄。这些发现为SLE的神经学与精神学表现中不同的神经解剖学异常提供了证据。
证据水平
2 技术效能：3期 J.MAGN.RESON.IMAGING 2017;46:150 - 158。
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