PT - JOURNAL ARTICLE AU - Jian Xu AU - Yuqi Cheng AU - Pei Chai AU - Zhaoping Lu AU - Haijun Li AU - Chunrong Luo AU - Xizhi Li AU - Lin Li AU - Qixin Zhou AU - Bing Chen AU - Jun Cao AU - Xiufeng Xu AU - Baoci Shan AU - Lin Xu AU - Jianfan Wen TI - White-matter Volume Reduction and the Protective Effect of Immunosuppressive Therapy in Systemic Lupus Erythematosus Patients with Normal Appearance by Conventional Magnetic Resonance Imaging AID - 10.3899/jrheum.090967 DP - 2010 Mar 15 TA - The Journal of Rheumatology PG - jrheum.090967 4099 - http://www.jrheum.org/content/early/2010/03/12/jrheum.090967.short 4100 - http://www.jrheum.org/content/early/2010/03/12/jrheum.090967.full AB - Objective The central nervous system (CNS) is often affected by systemic lupus erythematosus (SLE), but assessment of CNS outcomes using noninvasive cerebral structural measures remains in its infancy. Magnetic resonance imaging (MRI) with expert visual interpretation is critical to diagnosis, but does not permit quantitative measurements. Our pilot study investigated whether quantitative brain volumetric analyses could be used to detect white-matter (WM) abnormalities and responses to treatment in SLE (ClinicalTrials.gov: NCT00703742). Methods Forty-two pairs of SLE patients and healthy controls underwent high-resolution 3-dimensional structural MRI scans. Combining voxel-based morphometry and region of interest analyses, subtle WM volume abnormalities in whole brains from SLE patients were identified, and regional WM volume was calculated. Associations between WM volume and symptom severity, as well as the effects of immunosuppressive therapy, were then investigated. Results The WM volume of the SLE group was significantly decreased in the bilateral posterior and anterior crus of the internal capsule (PIC and AIC, respectively), the subgyral right frontal lobe, and left temporal lobe (p < 0.001). Regional WM volume (left PIC and right AIC) was correlated with SLEDAI scores. The WM volume of patients treated with immunosuppressive therapy was greater than that of patients who were never treated with immunosuppressive therapy. Conclusion Quantitative brain volumetric analyses detect brain injuries in WM for SLE that are not obvious by conventional MRI, and may be adequately sensitive and quantitative to measure the effect of therapeutic interventions in preventing brain injury and outcomes in SLE.