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BARCELONA — Atrophic brain changes in patients with juvenile systemic lupus erythematosus may improve upon remission and reduction in corticosteroid dose, contrary to what has been seen in magnetic resonance imaging studies of adult patients with the disease.
Using MRI, Dr. Simone Appenzeller and colleagues prospectively compared the voxel-based morphometry of white and gray matter in 10 juvenile SLE patients (mean age 13 years), and 10 healthy age- and sex-matched controls.
SLE duration was 14 months. Patients had active CNS manifestations (primary to SLE) at enrollment. The investigators excluded six patients who were unable to undergo MRI due to a phobia or conditions that could influence cerebral atrophy, Dr. Appenzeller said at the annual European Congress of Rheumatology.
At entry, the juvenile SLE patients had significantly less deep white matter volume in the anterior region of the corpus callosum and significantly less gray matter volume in the hippocampus and amygdala than controls. The decrease in volume of white and gray matter was independently associated with score on the Systemic Lupus Erythematosus International Collaborating Clinics/American College of Rheumatology damage index and with disease duration. Total corticosteroid dose was only tied to gray matter atrophy.
After at least 1 year of follow-up, repeat MRI in the SLE patients showed significant increases in white and gray matter.
These improvements could have been due to normal brain growth or a decrease in disease activity and corticosteroid dose. But Dr. Appenzeller said these changes suggest atrophy reduction because the degree of atrophy seen in patients correlated significantly with disease severity at study entry, independent of age. Dr. Appenzeller conducted the study at the State University of Campinas (Brazil), but is now at McGill University, Montreal.
“This finding indicates that children may respond differently to cerebral insults than adults and may even recover from severe involvement,” she concluded.
In a previous study of adult SLE patients, Dr. Appenzeller found significantly reduced gray and white matter volumes on MRI, vs. healthy age- and sex-matched controls; the atrophy continued to progress over 1.5 years of follow-up (Neuroimage 2007;34:694–701).
BARCELONA — Atrophic brain changes in patients with juvenile systemic lupus erythematosus may improve upon remission and reduction in corticosteroid dose, contrary to what has been seen in magnetic resonance imaging studies of adult patients with the disease.
Using MRI, Dr. Simone Appenzeller and colleagues prospectively compared the voxel-based morphometry of white and gray matter in 10 juvenile SLE patients (mean age 13 years), and 10 healthy age- and sex-matched controls.
SLE duration was 14 months. Patients had active CNS manifestations (primary to SLE) at enrollment. The investigators excluded six patients who were unable to undergo MRI due to a phobia or conditions that could influence cerebral atrophy, Dr. Appenzeller said at the annual European Congress of Rheumatology.
At entry, the juvenile SLE patients had significantly less deep white matter volume in the anterior region of the corpus callosum and significantly less gray matter volume in the hippocampus and amygdala than controls. The decrease in volume of white and gray matter was independently associated with score on the Systemic Lupus Erythematosus International Collaborating Clinics/American College of Rheumatology damage index and with disease duration. Total corticosteroid dose was only tied to gray matter atrophy.
After at least 1 year of follow-up, repeat MRI in the SLE patients showed significant increases in white and gray matter.
These improvements could have been due to normal brain growth or a decrease in disease activity and corticosteroid dose. But Dr. Appenzeller said these changes suggest atrophy reduction because the degree of atrophy seen in patients correlated significantly with disease severity at study entry, independent of age. Dr. Appenzeller conducted the study at the State University of Campinas (Brazil), but is now at McGill University, Montreal.
“This finding indicates that children may respond differently to cerebral insults than adults and may even recover from severe involvement,” she concluded.
In a previous study of adult SLE patients, Dr. Appenzeller found significantly reduced gray and white matter volumes on MRI, vs. healthy age- and sex-matched controls; the atrophy continued to progress over 1.5 years of follow-up (Neuroimage 2007;34:694–701).
BARCELONA — Atrophic brain changes in patients with juvenile systemic lupus erythematosus may improve upon remission and reduction in corticosteroid dose, contrary to what has been seen in magnetic resonance imaging studies of adult patients with the disease.
Using MRI, Dr. Simone Appenzeller and colleagues prospectively compared the voxel-based morphometry of white and gray matter in 10 juvenile SLE patients (mean age 13 years), and 10 healthy age- and sex-matched controls.
SLE duration was 14 months. Patients had active CNS manifestations (primary to SLE) at enrollment. The investigators excluded six patients who were unable to undergo MRI due to a phobia or conditions that could influence cerebral atrophy, Dr. Appenzeller said at the annual European Congress of Rheumatology.
At entry, the juvenile SLE patients had significantly less deep white matter volume in the anterior region of the corpus callosum and significantly less gray matter volume in the hippocampus and amygdala than controls. The decrease in volume of white and gray matter was independently associated with score on the Systemic Lupus Erythematosus International Collaborating Clinics/American College of Rheumatology damage index and with disease duration. Total corticosteroid dose was only tied to gray matter atrophy.
After at least 1 year of follow-up, repeat MRI in the SLE patients showed significant increases in white and gray matter.
These improvements could have been due to normal brain growth or a decrease in disease activity and corticosteroid dose. But Dr. Appenzeller said these changes suggest atrophy reduction because the degree of atrophy seen in patients correlated significantly with disease severity at study entry, independent of age. Dr. Appenzeller conducted the study at the State University of Campinas (Brazil), but is now at McGill University, Montreal.
“This finding indicates that children may respond differently to cerebral insults than adults and may even recover from severe involvement,” she concluded.
In a previous study of adult SLE patients, Dr. Appenzeller found significantly reduced gray and white matter volumes on MRI, vs. healthy age- and sex-matched controls; the atrophy continued to progress over 1.5 years of follow-up (Neuroimage 2007;34:694–701).