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Proton magnetic resonance spectroscopy of systemic lupus erythematosus involving the central nervous system

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Abstract

We examined 13 patients with neurological manifestations of systemic lupus erythematosus (SLE) based on previous and/or current neurological or psychotic episodes by magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) together with psychiatric and cognitive assessment. MRI was abnormal in 7 patients, showing high signal lesions in the white matter and/or cerebral atrophy. Proton MRS centred on white matter lesions in 5 patients showed a reduction in theN-acetyl aspartate creatine ratio compared with normal appearing white matter in the SLE group and in 10 healthy controls. This pattern of abnormality does not allow differentiation of SLE lesions from the chronic plaques occurring in multiple sclerosis. There was a very high incidence of current psychiatric morbidity in the SLE group, namely in 12 of the 13 patients. There was no correlation between the presence of current psychiatric involvement and/or cognitive dysfunction and abnormalities detected with MRI or MRS.

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References

  1. Arnold DL, Matthews PM, Francis GS, O'Connor, Antel J (1992) Proton magnetic resonance spectroscopic imaging for metabolic characterisation of de myelinating plaques. Ann Neurol 31:235–241

    PubMed  Google Scholar 

  2. Baker M (1973) Psychopathology in systemic lupus erythematosus. 1. Psychiatric observations. Semin Arthritis Rheum 3:95

    PubMed  Google Scholar 

  3. Benton AL (1968) Differential behavioral effects in frontal lobe disease. Neuropsychologia 6:53–60

    Google Scholar 

  4. Berry RG (1971) Lupus erythematosus. In, Minckler J. Pathology of the Nervous System. McGraw-Hill, New York, pp 1482–1488

    Google Scholar 

  5. Berry RG, Hodges JH (1965) Nervous system involvement in systemic lupus erythematosus. Trans Am Neurol Assoc 90:231–233

    PubMed  Google Scholar 

  6. Birken DL, Oldendorf WH (1989) Nacetyl-Aspartic acid: a literature review of a compound prominent in 1H NMR spectroscopic studies of brain. Neurosci Biobehav Rev 13:23–31

    PubMed  Google Scholar 

  7. Brenner RE, Munro PMG, Williams SCR, et al (1993) The proton NMR spectrum in actue EAE: the significance of the change in the Cho: Cr ratio. Magn Reson Med 29:737–745

    PubMed  Google Scholar 

  8. Bruhn H, Frahm J, Merboldt KD, Hanicke W, Hanefield F, Christen HJ (1992) Multiple Sclerosis in children: cerebral metabolic alterations monitored by localised proton magnetic resonance spectroscopy in vivo. Ann Neurol 32:140–150

    PubMed  Google Scholar 

  9. Coughlan AK, Hollows SE (1985) The Adult Memory and Information Processing Battery. Leeds

  10. Davie CA, Hawkins CP, Barker GJ, et al (1994) Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. Brain 117:49–58

    PubMed  Google Scholar 

  11. Frahm J, Merboldt KD, Hanicke W (1987) Localised proton spectroscopy using stimulated echoes. J Magn Reson 72:502–508

    Google Scholar 

  12. Frahm J, Bruhn H, Gyngell ML, Merboldt KD, Hanicke W, Sauter R (1989) Localised high resolution proton NMR spectroscopy using stimulated echoes: initial applications to human brain in vivo. Magn Reson Med 9:79–93

    PubMed  Google Scholar 

  13. Ginsburg KS, Wright EA, Larson MG, et al (1992) A controlled study of the prevalence of cognitive dysfunction in randomly selected patients with SLE. Arthritis Rheum 35:76–82

    Google Scholar 

  14. Hanly JG, Fisk JD, Sherwood G, et al (1992) Cognitive impairment in patients with SLE. J Rheumatol 19:562–567

    PubMed  Google Scholar 

  15. Harris EN, Hughes GRV (1985) Cerebral disease in systemic lupus erythematosus. Semin Immunopathol 8:251–266

    Google Scholar 

  16. Haseler LJ (1991) Evaluation of neuropsychiatric systemic lupus erythematosus by volume localised proton magnetic resonance spectroscopy (abstract). In: The Tenth Proceedings of the Society of Magnetic Resonance in Medicine, vol 1, p 229

  17. Hay EM, Black D, Huddy A, et al (1992) Psychiatric disorder and cognitive impairment in systemic lupus erythematosus. Arthritis Rheum 35:411–416

    PubMed  Google Scholar 

  18. Hume Adams J, Duchen LW (1992) In: Greenfield's Neuropathology. Arnold, London, p 229

    Google Scholar 

  19. Johnson RT, Richardson EP (1968) The neurological manifestations of systemic lupus erythematosus. Medicine 47:337–369

    PubMed  Google Scholar 

  20. Lim L, Ron MA, Ormerod IEC, et al (1988) Psychiatric and neurological manifestations in systemic lupus erythematosus. Q J Med 249:27–38

    Google Scholar 

  21. Matthews PM, Francis G, Antel J, Arnold DL (1991) Proton magnetic resonance spectroscopy for metabolic characterisation of plaques in Multiple Sclerosis. Neurology 41:1251–1256

    PubMed  Google Scholar 

  22. McIlwain H, Bachelard HS (1985) Biochemistry and the central nervous system. Churchill Livingstone, London, pp 336–370

    Google Scholar 

  23. McKenna P, Warrington EK (1983) The graded naming test. NFER-Nelson, Windsor

    Google Scholar 

  24. Miller DH, Austin SJ, Connelly A, Youl BD, Gadian DG, McDonald WI (1991) Proton magnetic resonance spectroscopy of an acute and chronic lesion in Multiple Sclerosis. Lancet 337:58–59

    PubMed  Google Scholar 

  25. Miller DH, Buchanan N, Barker G, et al (1992) Gadolinium-enhanced magnetic resonance imaging of the central nervous system in systemic lupus erythematosus. J Neurol 239:460–464

    PubMed  Google Scholar 

  26. Nelson HE (1971) National Adult Reading Test. NFER-Nelson, Windsor

    Google Scholar 

  27. Nelson HE (1976) A modified card sorting test sensitive to frontal defects. Cortex 12:313–324

    PubMed  Google Scholar 

  28. Papero PH, Bluestein HG, White P, Lipnick RN (1990) Neuropsychologic deficits and anti-neuronal antibodies in paediatric systemic SLE. Clin Exp Rheumatol 8:417–424

    PubMed  Google Scholar 

  29. Schonell FJ (1961) The psychology and teaching of reading. Oliver and Boyd, Edinburgh, pp 256–257

    Google Scholar 

  30. Simmons ML, Frondoza CG, Coyle IT (1991) Immunocytochemical localisation of N-acetyl-aspartate with monoclonal antibodies. Neuroscience 45:37–45

    PubMed  Google Scholar 

  31. Tan EM, Cohen ES, Fries JF, et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271

    PubMed  Google Scholar 

  32. Urenjak J, Williams SR, Gadian DG, Noble M (1993) Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 13:981–989

    PubMed  Google Scholar 

  33. Van Hecke P, Marchal G, Johannik K, Demaerel P, Wilms G, Carton H (1991) Human brain proton localised NMR spectroscopy in Multiple Sclerosis. Magn Reson Med 18:199–206

    PubMed  Google Scholar 

  34. Warrington EK (1984) Recognition Memory Test. NFER-Nelson, Windsor

    Google Scholar 

  35. Warrington EK, James M (1991) The Visual Object and Space Perception Battery. Thames Valley Test Co., Bury St. Edmunds

    Google Scholar 

  36. Willison JR (1988) Neuropsychological investigations of a set of mental speed tests. Ph. D. thesis, University of London, UK

    Google Scholar 

  37. Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms. An instruction manual for the Present State Examination and CATEGO program. Cambridge University Press, Cambridge

    Google Scholar 

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Davie, C.A., Feinstein, A., Kartsounis, L.D. et al. Proton magnetic resonance spectroscopy of systemic lupus erythematosus involving the central nervous system. J Neurol 242, 522–528 (1995). https://doi.org/10.1007/BF00867424

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  • DOI: https://doi.org/10.1007/BF00867424

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