Journal of Neurology

, Volume 248, Issue 7, pp 595–602

Neuropsychological dysfunction in systemic lupus erythematosus is not associated with changes in cerebral blood flow

  • Knut Waterloo
  • Roald Omdal
  • Hans Sjöholm
  • Wenche Koldingsnes
  • Eva A. Jacobsen
  • Johan A. Sundsfjord
  • Gunnar Husby
  • Svein Ivar Mellgren
ORIGINAL COMMUNICATION

Abstract

Cognitive dysfunction is found in a considerable proportion of patients with systemic lupus erythematosus (SLE). SPECT provides an estimate of regional cerebral blood flow (rCBF) which has been claimed to be sensitive to detect brain involvement in SLE. It is, however, uncertain if these perfusion defects are related to cognitive dysfunction. In the present study we investigated whether cerebral dysfunction assessed by neuropsychological measures was associated with changes in rCBF. Fifty-two SLE patients were examined with a battery of neuropsychological tests and MRI of the brain. For each patient 99mTC-HMPAO-SPECT was performed with the visual cortex as reference, and a reduction in rCBF of > 15 % was considered abnormal. Regional CBF was performed with an automated computer program quantitatively estimating blood perfusion in 16 symmetrical sectors of the brain. Several sectors of the brain showed varying areas of reduced rCBF with the temporal lobes most frequently involved. There were generally no associations between cognitive level of functioning and reduced rCBF. MRI demonstrated cerebral infarcts in 9 (17 %) patients. In general rCBF was reduced in all sectors of the brain in patients with infarcts, although statistical significant difference in rCBF between patients with and without infarcts was only seen in the parietal lobe. Several neuropsychological functions were influenced by the presence of cerebral infarcts. There was no significant association between immunological measures and SPECT findings or neuropsychological measures. Neuropsychological dysfunction in SLE was associated with the presence of cerebral infarcts detected by MRI, but not by changes in rCBF. SPECT seems to add little if any information to that obtained by clinical examination, neuropsychological testing, and MRI. Since anticoagulation may prevent cerebral infarcts, such prophylactic intervention may be of importance in preventing cognitive deterioration.

Key words SLE SPECT CBF MRI Cognitive dysfunction 

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Copyright information

© Steinkopff Verlag 2001

Authors and Affiliations

  • Knut Waterloo
    • 1
  • Roald Omdal
    • 3
  • Hans Sjöholm
    • 1
  • Wenche Koldingsnes
    • 3
  • Eva A. Jacobsen
    • 4
  • Johan A. Sundsfjord
    • 5
  • Gunnar Husby
    • 6
  • Svein Ivar Mellgren
    • 1
  1. 1.Department of Neurology, University Hospital of Tromsø, 9038 Tromsø, Norway Tel.: +47-7762-6000 Fax: +47-7762-7074 e-mail: knut.waterloo@rito.noNO
  2. 2.Department of Psychology, University of TromsøNO
  3. 3.Department of Clinical Medicine, University of TromsøNO
  4. 4.Department of Radiology, University Hospital of TromsøNO
  5. 5.Department of Nuclear Medicine, University Hospital of TromsøNO
  6. 6.Department of Rheumatology, The National University Hospital, Oslo, NorwayNO

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