Regional cerebral blood flow (rCBF) was studied by the intravenous 133Xe method in 38 patients with systemic lupus erythematosus (SLE); 21 patients had neuropsychiatric manifestations (N+) and 17 did not (N-). Twelve of the N+ patients had had neuropsychiatric episodes less than one year before measurement of CBF ("recent" N+), while seven patients in this group had had episodes over a year before measurement ("old" N+). The results were compared with those obtained from a group of 27 age-matched normal healthy subjects. It was found that, in most of the N+ and N- patients, rCBF was evenly distributed bilaterally, but there was a "patchwork" of high/normal and low flow areas. This disturbance of rCBF distribution was significantly greater in "recent" N+ patients than in "old" N- patients, but was not a function of the potential evolution of systemic lupus erythematosus. It was also found that there was a reduction in the physiological high frontal rCBF in the "old" N+ patients. No correlation could be found between rCBF, the topography of the neuropsychological lesions, other neurological investigations or the glucocorticoid dosage and treatment schedules.
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