Cortical Thickness and Subcortical Gray Matter Reductions in Neuropsychiatric Systemic Lupus Erythematosus

• Published in: PloS one Vol. 5; no. 3; p. e9302
• Main Authors: Jung, Rex E., Segall, Judith M., Grazioplene, Rachael G., Qualls, Clifford, Sibbitt, Wilmer L., Roldan, Carlos A.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.03.2010; Public Library of Science (PLoS)
• Subjects: Abnormalities; Activation; Adolescent; Adult; Age; Anatomy; Atrophy; Autoimmune diseases; Automation; Brain; Brain - pathology; Brain - physiology; Brain Mapping - methods; Brain research; Case-Control Studies; Caudate nucleus; Central nervous system; Chronic conditions; Clusters; Cognitive ability; Cognitive tasks; Comparative analysis; Cortex; Cortex (frontal); Cortex (occipital); Cortex (parietal); Cortex (temporal); Diagnostic software; Diagnostic systems; Edema; Female; Group effects; Humans; Huntingtons disease; Image analysis; Image processing; Image Processing, Computer-Assisted; Image segmentation; Internal medicine; Laboratories; Localization; Lupus; Lupus Vasculitis, Central Nervous System - diagnosis; Lupus Vasculitis, Central Nervous System - physiopathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medical research; Middle Aged; Nervous system; Neuroimaging; Neurological complications; Neurological Disorders/Cerebrovascular Disease; Neurological Disorders/Neuroimaging; Neurology; NMR; Nuclear magnetic resonance; Occipital lobes; Patients; Putamen; Radiology and Medical Imaging/Magnetic Resonance Imaging; Regression Analysis; Rheumatology/Systemic Lupus Erythematosos; Schizophrenia; Segmentation; Spina bifida; Stroke; Substantia grisea; Systemic lupus erythematosus; Temporal lobe; Thalamus; Thickness; Thinning; United States > US; New Mexico
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0009302

Within systemic lupus erythematosus (SLE) patients can be divided into groups with and without central nervous system involvement, the latter being subcategorized as neuropsychiatric systemic lupus erythematosus (NPSLE). While a number of research groups have investigated NPSLE, there remains a lack of consistent application of this diagnostic criteria within neuroimaging studies. Previous neuroimaging research suggests that SLE patients have reduced subcortical and regional gray matter volumes when compared to controls, and that these group differences may be driven by SLE patients with neuropsychiatric symptoms. The current study sought to compare measures of cortical thickness and subcortical structure volume between NPSLE, SLE, and healthy controls. We hypothesized that patients with NPSLE (N = 21) would have thinner cortex and reduced subcortical gray matter volumes when compared to SLE (N = 16) and control subjects (N = 21). All subjects underwent MRI examinations on a 1.5 Tesla Siemens Sonata scanner. Anatomical reconstruction and segmentation were performed using the FreeSurfer image analysis suite. Cortical and subcortical volumes were extracted from FreeSurfer and analyzed for group differences, controlling for age. The NPSLE group exhibited decreased cortical thickness in clusters of the left frontal and parietal lobes as well as in the right parietal and occipital lobes compared to control subjects. Compared to the SLE group, the NPSLE group exhibited comparable thinning in clusters of the frontal and temporal lobes. Controlling for age, we found that between group effects for subcortical gray matter structures were significant for the thalamus (F = 3.06, p = .04), caudate nucleus (F = 3.19, p = .03), and putamen (F = 4.82, p = .005). These results clarify previous imaging work identifying cortical atrophy in a mixed SLE and NPSLE group, and suggest that neuroanatomical abnormalities are specific to SLE patients diagnosed with neuropsychiatric symptoms. Future work should help elucidate the underlying mechanisms underlying the emerging neurobiological profile seen in NPSLE, as well as clarify the apparent lack of overlap between cortical thinning and functional activation results and other findings pointing to increased functional activation during cognitive tasks.