Worsening MRI Associated With New Neuropsychiatric Events in SLE

Radiological worsening of findings on brain magnetic resonance imaging (MRI) over time were associated with new neuropsychiatric events among patients with systemic lupus erythematosus (SLE), according to a recent study.

“Neuropsychiatric manifestations occur mostly in the early phases of the SLE course. Nonspecific alterations are evident in conventional brain MRI, regardless of clinically overt neuropsychiatric symptoms,” the researchers said.

In the study, the researchers assessed the prevalence of MRI abnormalities among 44 participants newly diagnosed with SLE, of whom 33 had SLE-associated neuropsychiatric events. They compared white matter lesions and atrophy between participants with SLE with neuropsychiatric symptoms and those with SLE without neuropsychiatric symptoms. In addition, they assessed the impact of MRI changes during follow up and clinical course of neuropsychiatric symptoms, as well as used Cox proportional hazard models to compare neuropsychiatric events with MRI data.

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At baseline, 21 participants (47.73%) had abnormal findings on MRI scans.

Seventeen participants experienced a new neuropsychiatric event during follow up, the researchers noted. They also observed worsening in repeated MRI in 12 participants (27.27%).

In addition, they found worsening MRI was associated with a higher occurrence of new neuropsychiatric events during follow up, with an adjusted hazard ratio of 3.946 (1.175-13.253).

“In our study, radiological worsening of repeated brain MRI was associated with new neuropsychiatric events,” the researchers concluded. “Baseline MRI is useful in patients with an early diagnosis of SLE, allowing comparison with subsequent scans.”

Reference

Silvagni E, Bortoluzzi A, Borrelli M, Padovan M, Furini F, Govoni M. Conventional brain magnetic resonance imaging in the longitudinal evaluation of newly diagnosed systemic lupus erythematosus patients: A retrospective analysis from a single-centre cohort [published online March 5, 2020]. Lupus. doi:10.1177/0961203320909955