Original Research

Multi-voxel proton magnetic resonance spectroscopy changes in neuropsychiatric lupus patients

Page l. Wang, Richard E. Harris, Thomas L. Chenevert, William J. McCune, Pia C. Sundgren
South African Journal of Radiology | Vol 20, No 1 | a974 | DOI: https://doi.org/10.4102/sajr.v20i1.974 | © 2016 Page l. Wang, Richard E. Harris, Thomas L. Chenevert, William J. McCune, Pia C. Sundgren | This work is licensed under CC Attribution 4.0
Submitted: 03 January 2016 | Published: 14 June 2016

About the author(s)

Page l. Wang, Alta Vista Radiology, Paradise Valley, United States
Richard E. Harris, Department of Anesthesiology, University of Michigan Hospital, United States
Thomas L. Chenevert, Department of Radiology, University of Michigan Hospital, United States
William J. McCune, Department of Rheumatology/Internal Medicine, University of Michigan Hospital, United States
Pia C. Sundgren, Department of Diagnostic Radiology, Lund University, Skane University Hospital, Sweden


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Abstract

Purpose: In this prospective study, we used 2D chemical shift imaging (CSI), a multi-voxel proton spectroscopy technique, to evaluate the brain metabolites on conventional magnetic resonance imaging (MRI) in normal-appearing white and grey matter in systemic lupus erythematosus (SLE) patients with neuropsychiatric symptoms (NPSLE); without neuropsychiatric symptoms (non-NPSLE); and healthy controls (HCs). Our objective was to find metabolites that discriminated NPSLE patients from the non-NPSLE and HC cohorts.

Materials and methods: The study included 23 NPSLE patients, 20 non-NPSLE patients, and 21 HCs. A clinical assessment including the SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics (SLICC) scores was conducted. All patients underwent conventional MRI and 2D CSI technique to acquire the following metabolic ratios: NAA/Cr, Cho/Cr, and Cho/NAA in the anterior and posterior insula, anterior frontal and parietal white and grey matter, thalamus, basal ganglia, and occipital grey matter.

Results: In terms of metabolic differences, the NPSLE patients had significant differences compared with the non-NPSLE and HC groups in the: left posterior insula (increased Cho/NAA; p = 0.008), right internal capsule (increased Cho/Cr; p < 0.05), left thalamus (increased NAA/Cr; p = 0.011), anterior grey matter (increased NAA/Cr; p = 0.004), posterior grey matter (increased Cho/NAA; p = 0.016), anterior white matter (increased NAA/Cr; p = 0.012), and left posterior white matter (increased Cho/NAA; p = 0.022). The NPSLE patients showed significantly higher SLEDAI scores (p < 0.001).

Conclusion: We found several significant distinct metabolic differences between NPSLE and non-NPSLE/HC patients in various brain locations.

Keywords: systemic lupus erythematosus; SLE; neuropsychiatric systemic lupus erythematosus; NPSLE; spectroscopy


Keywords

systemic lupus erythematosus; SLE; neuropsychiatric systemic lupus erythematosus; NPSLE; spectroscopy

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