Quantitative Neuroimaging Advances in the Measurement of Brain Injury but Not Brain Function in Systemic Lupus Erythematosus

摘要

Appenzeller and colleagues'1 study contributes important information about a successful methodological approach to understand one manifestation of the brain injury that occurs in some patients with systemic lupus erythematosus (SLE), namely, the "hyperintense white matter lesions." Borrowing from the successful strategy used in advancing the understanding disease burden in multiple sclerosis, Appenzeller and colleagues1 have demonstrated that the quantitative magnetic resonance imaging measure of total load of white matter (WM) lesions is a useful biomarker that correlated with a history of central nervous system (CNS) symptoms, serum anti-phospholipid antibody levels, and total steroid dose at baseline imaging. The study design in 120 patients and 44 healthy control subjects is solid, and includes the basic foundations for any study of SLE, including strict disease criteria for diagnosis, description of associated illnesses and pharmacological therapy history, sex- and age-matched control subjects without neurological or psychiatric illness, attention to disease duration, activity, and damage, as well as timing of the onset of new symptoms. Importantly, SLE patients with concomitant disease(s) capable of affecting the CNS were excluded from this study#