Cerebral Small Vessel Disease burden is increased in Systemic Lupus Erythematosus

Stewart J. Wiseman, Mark E. Bastin, Charlotte L. Jardine, Gayle Barclay, Iona F. Hamilton, Elaine Sandeman, David Hunt, E. Nicole Amft, Susan Thomson, Jill F. F. Belch, Stuart H. Ralston, Joanna M. Wardlaw (Lead / Corresponding author)

Research output: Contribution to journalArticle

25 Citations (Scopus)
153 Downloads (Pure)

Abstract

BACKGROUND AND PURPOSE: Systemic lupus erythematosus (SLE) increases stroke risk, but the mechanism is uncertain. This study aimed to determine the association between SLE and features on neuroimaging of cerebral small vessel disease (SVD), a risk factor for stroke.

METHODS: Consecutive patients attending a clinic for SLE were recruited. All patients underwent brain magnetic resonance imaging; had blood samples taken for markers of inflammation, endothelial dysfunction, cholesterol, and autoantibodies; and underwent cognitive and psychiatric testing. The data were compared with sex- and age-matched healthy controls and patients with minor stroke. Features of SVD were measured, a total SVD score calculated, and associations sought with vascular risk factors, cognition, SLE activity, and disease duration.

RESULTS: Fifty-one SLE patients (age: 48.8 years; SD: 14.3 years) had a greater total SVD score compared with healthy controls (1 versus 0; P<0.0001) and stroke patients (1 versus 0; P=0.02). There were higher perivascular spaces and deep white matter hyperintensity scores and more superficial brain atrophy in SLE patients versus healthy controls. Despite fewer vascular risk factors than similarly aged stroke patients, SLE patients had similar or more of some SVD features. The total SVD score was not associated with SLE activity, cognition, disease duration, or any blood measure.

CONCLUSIONS: In this data set, SLE patients had a high burden of SVD features on magnetic resonance imaging, particularly perivascular spaces. A larger longitudinal study is warranted to determine the causes of SVD features in SLE and clinical implications.

Original languageEnglish
Pages (from-to)2722-2728
Number of pages7
JournalStroke
Volume47
Issue number11
Early online date4 Oct 2016
DOIs
Publication statusPublished - Nov 2016

    Fingerprint

Keywords

  • Autoimmune diseases
  • Biomarkers
  • C-reactive protein
  • Inflammation
  • Systemic Lupus Erythematosus

Cite this

Wiseman, S. J., Bastin, M. E., Jardine, C. L., Barclay, G., Hamilton, I. F., Sandeman, E., Hunt, D., Amft, E. N., Thomson, S., Belch, J. F. F., Ralston, S. H., & Wardlaw, J. M. (2016). Cerebral Small Vessel Disease burden is increased in Systemic Lupus Erythematosus. Stroke, 47(11), 2722-2728. https://doi.org/10.1161/STROKEAHA.116.014330