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Regional cerebral perfusion correlates with anxiety in neuropsychiatric SLE: evidence for a mechanism distinct from depression.

Authors
  • Papadaki, E1, 2
  • Kavroulakis, E1
  • Bertsias, G3, 4
  • Fanouriakis, A3, 5
  • Karageorgou, D1
  • Sidiropoulos, P3
  • Papastefanakis, E6
  • Boumpas, D T3, 5, 7, 8
  • Simos, P2, 6
  • 1 Department of Radiology, University Hospital of Heraklion, Crete, Greece. , (Greece)
  • 2 Institute of Computer Science, Foundation of Research and Technology-Hellas, Heraklion, Greece. , (Greece)
  • 3 Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece. , (Greece)
  • 4 Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology-Hellas, Heraklion, Greece. , (Greece)
  • 5 4th Department of Internal Medicine, National and Kapodestrian University of Athens, Athens, Greece. , (Greece)
  • 6 Department of Psychiatry, University Hospital of Heraklion, Crete, Greece. , (Greece)
  • 7 Laboratory of Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece. , (Greece)
  • 8 Joint Academic Rheumatology Program, National and Kapodestrian University of Athens, Athens, Greece. , (Greece)
Type
Published Article
Journal
Lupus
Publisher
SAGE Publications
Publication Date
Dec 01, 2019
Volume
28
Issue
14
Pages
1678–1689
Identifiers
DOI: 10.1177/0961203319887793
PMID: 31718491
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The study examined the hypothesis that hypoperfusion in brain areas known to be involved in emotional disturbances in primary psychiatric disorders is also linked to emotional difficulties in systemic lupus erythematosus (SLE) and that these are not secondary to the physical and social burden incurred by the disease. Nineteen SLE patients without overt neuropsychiatric manifestations (non-NPSLE), 31 NPSLE patients, and 23 healthy controls were examined. Dynamic susceptibility contrast MRI was used and cerebral blood flow and cerebral blood volume values were estimated in six manually selected regions of interest of brain regions suspected to play a role in anxiety and depression (dorsolateral prefrontal cortex, ventromedial prefrontal cortex, anterior cingulate cortex, hippocampi, caudate nuclei and putamen). NPSLE patients reported high rates of anxiety and depression symptomatology. Significantly reduced cerebral blood flow and cerebral blood volume values were detected in the NPSLE group compared to healthy controls in the dorsolateral prefrontal cortex and ventromedial prefrontal cortex, bilaterally. Within the NPSLE group, anxiety symptomatology was significantly associated with lower perfusion in frontostriatal regions and in the right anterior cingulate gyrus. Importantly, the latter associations appeared to be specific to anxiety symptoms, as they persisted after controlling for depression symptomatology and independent of the presence of visible lesions on conventional MRI. In conclusion, hypoperfusion in specific limbic and frontostriatal regions is associated with more severe anxiety symptoms in the context of widespread haemodynamic disturbances in NPSLE.

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