[1]Department of Rheumatology and Immunology, First Affiliated Hospital, Kunming Medical University, Kunming, China.
This study explores the relationship among autoantibodies, clinical characters and microstructural hippocampal atrophy in SLE patients without major neuropsychiatric manifestation (NPSLE). Ninety-five NPSLE patients without obvious cerebral deficits, as determined by conventional MRI, as well as 101 control subjects, underwent high-resolution structural MRI. Volume and density of hippocampus were calculated respectively for each individual, and correlations between the volume and density of hippocampus, symptom severity, clinical characters, immunosuppressive agent (ISA), and autoantibody levels were assessed. Both the whole-hippocampal volume (HIPV) and whole-hippocampal density (HIPD) of the SLE group decreased compared to controls. The effect of sex on HIPV and HIPD was also observed with whole-HIPV was significantly decreased in women compared with men. There was no association between the immunesupressors and HIPV/HIPD, nor did steroid. The SLEDAI scores was negatively correlated with the density of left hippocampus (LHIPD). However, our results showed a positive correlation between SLEDAI scores and the density of right hippocampus (RHIPD). The urine protein was negatively correlated with both LHIPD and RHIPD. The volume of left hippocampus (LHIPV) of the anti-SSA/Ro52kD antibody-positive patients was significantly reduced compared with the antibody-negative patients, similar result was found for the anti-dsDNA positive and negative patients. ISAs did not show protective effects in hippocampus in this study. Thus, obvious hippocampal atrophy can occur very early even before the development of significant symptoms and specific autoantibodies might contribute to the reduction of LHIPV in NPSLE patients. The presence of these specific autoantibodies might help identify early brain damage in NPSLE patients.
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