Diffusion tensor imaging in neuropsychiatric systemic lupus erythematosus

BACKGROUND Neuropsychiatric systemic lupus erythematosus (NPSLE) is associated with increased morbidity and mortality. METHODS We used Diffusion Tensor Imaging (DTI) to assess white matter abnormalities in seventeen NPSLE patients, sixteen SLE patients without NPSLE, and twenty age- and gender-matched controls. RESULTS NPSLE patients differed significantly from SLE and control patients in white matter integrity of the body of the corpus callosum, the left arm of the forceps major and the left anterior corona radiata. CONCLUSIONS Several possible mechanisms of white matter injury are explored, including vascular injury, medication effects, and platelet or fibrin macro- or microembolism from Libman-Sacks endocarditis.