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Alicja Kalinowska-Łyszczarz, Mikołaj A Pawlak, Aleksandra Wyciszkiewicz, Katarzyna Pawlak-Buś, Piotr Leszczyński, Mariusz Puszczewicz, Włodzimierz Paprzycki, Wojciech Kozubski, Sławomir Michalak
OBJECTIVE: Central nervous system (CNS) involvement in systemic lupus erythematosus (SLE) remains poorly understood. Damage within the CNS is driven by the autoimmune response; however, immunopathophysiology of neuropsychiatric (NP) SLE is multifactorial. Immune cell neurotrophin production could be neuroprotective against autoimmunity-driven CNS damage, as has been shown in multiple sclerosis. The aim of this study was to establish whether immune cell neurotrophin production is associated with damage severity in NPSLE...
March 14, 2018: Neuroimmunomodulation
B Cannerfelt, J Nystedt, A Jönsen, J Lätt, D van Westen, A Lilja, A Bengtsson, P Nilsson, J Mårtensson, P C Sundgren
Aim The aim of this study was to evaluate the extent of white matter lesions, atrophy of the hippocampus and corpus callosum, and their correlation with cognitive dysfunction (CD), in patients diagnosed with systemic lupus erythematosus (SLE). Methods Seventy SLE patients and 25 healthy individuals (HIs) were included in the study. To evaluate the different SLE and neuropsychiatric SLE (NPSLE) definition schemes, patients were grouped both according to the American College of Rheumatology (ACR) definition, as well as the more stringent ACR-Systemic Lupus International Collaborating Clinics definition...
January 1, 2018: Lupus
Jessika Nystedt, Peter Mannfolk, Petra Nilsson, Anders Bengtsson, Andreas Jönsen, Pia C Sundgren, Olof Strandberg
PURPOSE: To investigate resting state functional connectivity of lupus-patients and associated subgroups according to the ACR NPSLE case definitions (ACR ad Hoc 1999). Additionally, we investigated whether or not the observed alterations correlated with disease duration, SLE-disease activity index-2000 (SLEDAI-2k) and Systemic Lupus International Collaborating Clinical/ACR organ damage index (SDI)-scores. MATERIAL AND METHOD: Anatomical 3T MRI and resting state-fMRI (rs-fMRI) were performed in 61 female lupus-patients (mean age = 37...
March 2, 2018: Brain Connectivity
Shuang Liu, Yuqi Cheng, Yueyin Zhao, Hongjun Yu, Aiyun Lai, Zhaoping Lv, Xiufeng Xu, Chunrong Luo, Baoci Shan, Lin Xu, Jian Xu
The aim of the study was to find structural brain changes in systemic lupus erythematosus patients without major neuropsychiatric manifestations [non-neuropsychiatric systemic lupus erythematosus (non-NPSLE)] using quantitative magnetic resonance imaging (MRI) and possible associations with clinical characteristics. 89 non-NPSLE patients with normal conventional MRI and 84 healthy controls (HCs) were recruited. The whole brain gray matter volume (GMV) and white matter volume (WMV) were calculated for each individual...
2018: Frontiers in Psychiatry
Osman Perez, Kairavee Dave, Aimee Almanzar, Tajul Prodhan, Livasky Concepion
Neuropsychiatric systemic lupus erythematosus (NPSLE) has a wide variety of neurologic and psychiatric features. NPSLE symptoms and the psychotic features of primary psychiatric disorders often overlap with each other. These psychotic features often mask and delay the diagnosis of NPSLE. We present the case of a 59-year-old female previously diagnosed with bipolar disorder and generalized anxiety disorder presenting with altered mental status (AMS), subsequently diagnosed with neuropsychiatric lupus. Initially, medication overdose was suspected as an empty bottle of trazodone was found beside her...
October 23, 2017: Curēus
Jessika Nystedt, Markus Nilsson, Andreas Jönsen, Petra Nilsson, Anders Bengtsson, Åsa Lilja, Jimmy Lätt, Peter Mannfolk, Pia C Sundgren
BACKGROUND: The purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms. METHODS: Structural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2-52.2 years) and 21 healthy controls (mean age 36.7 years, range 23...
February 7, 2018: Arthritis Research & Therapy
B Leslie, S F Crowe
Cognitive deficits are common in patients with systemic lupus erythematosus (SLE) regardless of overt neuropsychiatric involvement; however, a clear neuropsychological profile of SLE has not emerged. This study undertook a literature search of the PubMed, Scopus and Ovid (PsychINFO) databases for studies investigating cognitive alterations in SLE, using standardized neuropsychological (NP) measures. The data were analysed using meta-analytical procedures. The results support the observation that relative to healthy controls, SLE (regardless of overt neuropsychiatric involvement) is associated with statistically significant, small effect-sized deficits in visual attention, cognitive fluency, immediate visual memory and visual reasoning...
January 1, 2018: Lupus
Meghan Romba, Yujie Wang, Shu-Ching Hu, Sandeep Khot
Dystonia as a manifestation of neuropsychiatric lupus erythematosus (NPSLE) is uncommon. We report a 25-year-old woman who experienced progressive confusion, reduced speech, and difficulty opening her mouth approximately 2 weeks after development of a facial rash. Brain imaging showed bilateral, symmetric signal abnormalities within the basal ganglia and subcortical white matter. Despite treatment with high-dose steroids, she continued to have difficulty speaking with evidence of jaw dystonia on examination...
January 2018: Neurohospitalist
Isabel Ferreira, Sara Croca, Maria Gabriella Raimondo, Manjit Matharu, Sarah Miller, Ian Giles, David Isenberg, Yiannis Ioannou, John G Hanly, Murray B Urowitz, Nicole Anderson, Cynthia Aranow, Anca Askanase, Sang-Cheol Bae, Sasha Bernatsky, Ian N Bruce, Jill Buyon, Ann E Clarke, Mary Anne Dooley, Paul Fortin, Ellen Ginzler, Dafna Gladman, Caroline Gordon, Murat Inanc, Søren Jacobsen, Kenneth Kalunian, Diane Kamen, Munther Khamashta, Sam Lim, Susan Manzi, Joan Merrill, Ola Nived, Christine Peschken, Michelle Petri, Rosalind Ramsey-Goldman, Guillermo Ruiz-Irastorza, Jorge Sanchez-Guerrero, Kristjan Steinson, Gunnar K Sturfelt, Ronald van Vollenhoven, Daniel J Wallace, Asad Zoma, Anisur Rahman
BACKGROUND: In patients with systemic lupus erythematosus (SLE) there is no serological test that will reliably distinguish neuropsychiatric (NP) events due to active SLE from those due to other causes. Previously we showed that serum levels of nitrated nucleosomes (NN) were elevated in a small number of patients with NPSLE. Here we measured serum NN in samples from a larger population of patients with SLE and NP events to see whether elevated serum NN could be a marker for NPSLE. METHODS: We obtained serum samples from patients in the Systemic Lupus International Collaborative Clinics (SLICC) inception cohort...
December 22, 2017: Arthritis Research & Therapy
Efrosini Papadaki, Antonis Fanouriakis, Eleftherios Kavroulakis, Dimitra Karageorgou, Prodromos Sidiropoulos, George Bertsias, Panagiotis Simos, Dimitrios T Boumpas
OBJECTIVES: Cerebral perfusion abnormalities have been reported in systemic lupus erythematosus (SLE) but their value in distinguishing lupus from non-lupus-related neuropsychiatric events remains elusive. We examined whether dynamic susceptibility contrast-enhanced perfusion MRI (DSC-MRI), a minimally invasive and widely available method of cerebral perfusion assessment, may assist neuropsychiatric SLE (NPSLE) diagnosis. METHODS: In total, 76patients with SLE (37 primary NPSLE, 16 secondary NPSLE, 23 non-NPSLE) and 31 healthy controls underwent conventional MRI (cMRI) and DSC-MRI...
December 19, 2017: Annals of the Rheumatic Diseases
Wessam E Sharaf-Eldin, Nirmeen A Kishk, Yehia Z Gad, Heba Hassan, Mohamed A M Ali, Maha S Zaki, Mohamed R Mohamed, Mona L Essawi
BACKGROUND: Although misdiagnosis of neuromyelitis optica spectrum disorder (NMOSD) with neuropsychiatric systemic lupus erythematosus (NPSLE) or multiple sclerosis (MS) is not infrequent, reliable biomarkers remains an unmet need. Extracellular microRNAs (miRNAs) represent a worthy avenue to identify biomarkers for differential diagnosis. We aimed to explore the potential role of some selected circulating miRNAs as biomarkers for the differential diagnosis in immune-mediated neuroinflammatory diseases...
December 15, 2017: Journal of the Neurological Sciences
H Muhammed, M Goyal, V Lal, S Singh, V Dhir
Objectives The objectives of this paper are to look at the prevalence of neuropsychiatric manifestations and assess their impact on quality of life in North Indian lupus patients. Methods The study included consecutive patients with systemic lupus erythematosus (SLE) who were older than 18 years and met the SLICC 2012 criteria. A diagnosis of a neuropsychiatric syndrome was made as per ACR 1999 definitions. Manifestations occurring at any point in time after the diagnosis of SLE were considered if a reliable history and medical records were available...
January 1, 2017: Lupus
Kunihiro Ichinose, Kaname Ohyama, Kaori Furukawa, Osamu Higuchi, Akihiro Mukaino, Katsuya Satoh, Shunya Nakane, Toshimasa Shimizu, Masataka Umeda, Shoichi Fukui, Ayako Nishino, Hideki Nakajima, Tomohiro Koga, Shin-Ya Kawashiri, Naoki Iwamoto, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Mari Yoshida, Naotaka Kuroda, Atsushi Kawakami
Neuropsychiatric systemic lupus erythematosus (NPSLE) is often difficult to diagnose and distinguish from other diseases, because no NPSLE-specific antibodies have been identified. We developed a novel proteomic strategy for identifying and profiling antigens in immune complexes in the cerebrospinal fluid (CSF), and applied this strategy to 26 NPSLE patients. As controls, we also included 25 SLE patients without neuropsychiatric manifestations (SLE), 15 with relapsing remitting multiple sclerosis (MS) and 10 with normal pressure hydrocephalus (NPH)...
November 18, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Y Meng, H Sun, J J Xu, R Li, Y Wang
Objective: To analyze the clinical significance of anti- ubiquitin C-terminal hydrolase L1(UCHL-1)autoantibodies in neuropsychiatric systemic lupus erythematosus (NPSLE). Methods: Autoantibodies in cerebrospinal fluid specimen of 56 inpatients were detected by using indirect enzyme-linked immunosorbent assay (ELISA) and the fullmedical history and clinical manifestations were analyzed retrospectively. Results: The levels of anti-UCHL-1 autoantibodies in NPSLE group were significant higher than that in other controls (P<0...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Beatriz Lavras Costallat, Daniel Miranda Ferreira, Aline Tamires Lapa, Letícia Rittner, Lilian Tereza Lavras Costallat, Simone Appenzeller
Diffusion tensor imaging (DTI) maps the brain's microstructure by measuring fractional anisotropy (FA) and mean diffusivity (MD). This systematic review describes brain diffusion tensor Magnetic resonance imaging (MRI) studies in systemic lupus erythematosus (SLE).The literature was reviewed following the PRISMA guidelines and using the terms "lupus", "systemic lupus erythematosus", "SLE", "diffusion tensor imaging", "DTI", "white matter" (WM), "microstructural damage", "tractography", and "fractional anisotropy"; the search included articles published in English from January 2007 to April 2017...
November 3, 2017: Autoimmunity Reviews
Zhen Tan, Yingbo Zhou, Xiangpei Li, Guosheng Wang, Jinhui Tao, Li Wang, Yan Ma, Xiaomei Li
The objective of this study is to analyze clinical manifestations, features of imaging, and laboratory assessment of patients with neuropsychiatric SLE (NPSLE) for better diagnosis and outcome prediction. One hundred eighteen NPSLE patients admitted to the Anhui Provincial Hospital in Hefei, China, between January 2006 and December 2016 were enrolled and analyzed retrospectively. All patients fulfilled the American College of Rheumatology revised classification criteria for SLE. Patients with NPSLE fulfilled the American College of Rheumatology (ACR) nomenclature and case definitions...
November 4, 2017: Clinical Rheumatology
Simone Mader, Venkatesh Jeganathan, Yoshiyuki Arinuma, Yuichiro Fujieda, Irena Dujmovic, Jelena Drulovic, Yuka Shimizu, Yuko Sakuma, Joel N H Stern, Cynthia Aranow, Meggan Mackay, Shinsuke Yasuda, Tatsuya Atsumi, Shunsei Hirohata, Betty Diamond
OBJECTIVE: IgG anti-DWEYS antibodies cross-reactive with DNA and the N-methyl-d-aspartate receptor subunits GluN2A and GluN2B are known to be associated with neuropsychiatric systemic lupus erythematosus (NPSLE). IgG anti-DWEYS have not been investigated in demyelinating NPSLE or in another demyelinating disorder, neuromyelitis optica spectrum disorder (NMOSD), which is a disease also found mainly in young women and associated with aquaporin 4 (AQP-4) or myelin oligodendrocyte glycoprotein (MOG) antibodies...
February 2018: Arthritis & Rheumatology
Kashif Jafri, Sarah L Patterson, Cristina Lanata
Neuropsychiatric systemic lupus erythematosus (NPSLE) encompasses a variety of phenomena. Manifestations are focal or diffuse, and correlate with disease mechanisms. Recent understanding of the contribution of blood-brain barrier dysfunction to the passage of circulating antineuronal antibodies into the brain parenchyma has shed light on pathogenesis. Correct attribution of neuropsychiatric manifestations to SLE remains a challenge, but validated attribution models will help. Diagnosis relies on characteristic clinical manifestations, SLE disease activity, antibody measurements, cerebrospinal fluid findings, specific neuroimaging findings, and exclusion of alternative etiologies...
November 2017: Rheumatic Diseases Clinics of North America
Tomoyuki Asano, Hiromi Ito, Yoshinobu Kariya, Kyoka Hoshi, Akioh Yoshihara, Yoshikazu Ugawa, Hideharu Sekine, Shunsei Hirohata, Yoshiki Yamaguchi, Shuzo Sato, Hiroko Kobayashi, Kiyoshi Migita, Hiromasa Ohira, Yasuhiro Hashimoto, Hiroshi Watanabe
Although quotient of alpha2 macroglobulin (Qα2MG) was previously reported to be useful for the evaluation of blood-brain barrier (BBB) function, it is not commonly used. We therefore evaluated BBB function among the various subsets of neuropsychiatric systemic lupus erythematosus (NPSLE) using quotient Q α2MG. Furthermore, we determined the correlation between Q α2MG and cerebrospinal (CSF) interleukin (IL)-6 level and quotient complement component 3 (Q C3). To determine intrathecal production of C3, the C3 index (Q C3/Q α2MG) was also calculated...
2017: PloS One
Eduardo de Almeida Macêdo, Simone Appenzeller, Lilian Tereza Lavras Costallat
Neuropsychiatric lupus (NPSLE) is described in 12-95% of patients with systemic lupus erythematosus (SLE). Anxiety disorders are among the most frequent manifestations of NPSLE, occurring in 4-85% of these patients. Several diagnostic tools, such as Hospital Anxiety and Depression Scale (HADS), have been used to assess anxiety in clinical studies in SLE, but there is a lack of data on the performance of these questionnaires in the disease. This study aimed to assess the performance of HADS for the detection of anxiety in male and female patients with SLE, also investigating possible gender differences in this aspect...
December 2017: Rheumatology International
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