| Discrepancy between regional cerebral blood flow and glucose metabolism of the brain in systemic lupus erythematosus patients with normal brain magnetic resonance imaging findings. | |
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MedLine Citation:
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PMID: 9920015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: In this study, 2 updated brain-imaging modalities, technetium-99m hexamethylpropylene amine oxime-single-photon-emission computed tomography (HMPAO-SPECT) and fluorine-18 2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET), were used to simultaneously detect regional cerebral blood flow (rCBF) and glucose metabolism of the brain in patients with systemic lupus erythematosus (SLE). METHODS: Twenty-five female SLE patients, ages 25-40 years, were enrolled in this study and assigned to 1 of 2 groups. Group 1 consisted of 13 patients with neuropsychiatric manifestations (7 had major and 6 had minor manifestations). Group 2 consisted of 12 patients without neuropsychiatric manifestations. Serum levels of anticardiolipin antibodies (aCL) and anti-ribosomal P antibodies (anti-P) were measured. All patients had normal brain magnetic resonance imaging (MRI) findings. Ten healthy female volunteers also underwent brain MRI, HMPAO-SPECT, and FDG-PET for comparison. RESULTS: 99mTc-HMPAO-SPECT revealed hypoperfusion lesions in 11 (44%) of 25 SLE patients, including 9 (69%) of the 13 patients in group 1, 7 (100%) of the 7 patients with major manifestations, 2 (33%) of the 6 patients with minor manifestations, and 2 (17%) of the 12 patients in group 2. Parietal lobes were the areas most commonly involved. FDG-PET revealed hypometabolism in 7 (54%) of the group 1 patients, 6 (86%) of the 7 patients with major manifestations, and 1 (17%) of the 6 patients with minor manifestations. Temporal lobes were the most commonly involved areas. However, no significant hypometabolism brain lesions were found in group 2 patients. All of the 4 patients with headaches and dizziness or headaches alone had normal findings on HMPAO-SPECT and FDG-PET. Nine (36%) of the 25 patients were positive for aCL. However, the presence of aCL was not related to neuropsychiatric manifestations or to HMPAO-SPECT or FDG-PET findings. Five (20%) of the 25 patients had anti-P antibodies and psychosis/depression. CONCLUSION: In patients with normal brain MRI findings, decreases in glucose metabolism coupled with decreases in rCBF are associated with serious neuropsychiatric SLE (NPSLE) presentations, while normal glucose metabolism with decreases in rCBF may be found in SLE patients with or without NPSLE. |
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Authors:
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C H Kao; Y J Ho; J L Lan; S P Changlai; K K Liao; P U Chieng |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Arthritis and rheumatism Volume: 42 ISSN: 0004-3591 ISO Abbreviation: Arthritis Rheum. Publication Date: 1999 Jan |
Date Detail:
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Created Date: 1999-02-04 Completed Date: 1999-02-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 61-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Brain / metabolism*, pathology* Cerebrovascular Circulation* / physiology Female Glucose / metabolism* Humans Lupus Erythematosus, Systemic / diagnosis*, metabolism, physiopathology Magnetic Resonance Imaging* Regional Blood Flow Technetium Tc 99m Exametazime / diagnostic use Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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100504-35-6/Technetium Tc 99m Exametazime; 50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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