Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose Systemic sclerosis (SSc) is a systemic disease characterized by cutaneous and visceral fibrosis, presence of autoantibodies and vasculopathy. The central nervous system has, however, been rarely studied. Therefore the aim of this study is to determine cerebral and corpus callosum abnormalities in SSc and to determine the possible relationship between atrophy and SSc related features.
Methods A total of 41 SSc patients (37 female; mean age=50.8; SD=13.2) and sixty-six health age and sex matched volunteers (57 female; mean age=51.4; SD=12.3) were included. A complete clinical, laboratory and neurological evaluation was performed in all subjects. Cognitive evaluation was performed using the Montreal Cognitive Assessment (MoCA). Individual with scores≤26 were considered impaired. Mood disorders were determined through Beck´s Depression and Beck´s Anxiety Inventories. SSc patients were further assessed for clinical and laboratory SSc manifestations, disease activity (Valentini Activity Index), severity activity (Medsger Severity Index). Total dose of corticosteroids and other immunosuppressant medications used since the onset of the disease were calculated. MRI scans were performed in a 3T Phillips® scanner. Sagittal T1 weighted were used for manual volumetric measurements. Volumes ≤ 2 standard deviations from the means of controls were considered abnormal. Non-parametric tests and correlation were used for statistical analysis.
Results We included 27 (65.9%) limited SSc (lSSc) and 14 (34.1%) diffuse SSc (dSSc) with mean disease duration of 10.4 (SD 6.9) years. Active disease was identified in 12 (29.3%), abnormal neurological exam in 27 (65.8%) and cognitive impairment in 36 (87.8%) SSc patients. Mood disorders were identified in 25 (60.9%) SSC patients. All controls had normal neurological examinations. In SSc, cerebral (mean volume=8975.4 cm3;; SD= 165.1) and corpus callosum (mean volume = 96.2 cm3;; SD= 8,7) were significantly smaller when compared to cerebral (mean volume = 9514.2 cm3;; SD= 176.1; p= 0.03) and corpus callosum (mean volume=114.3 cm3;; SD=8,4 ; p=0.02) volumes of controls. When analyzed separately dSSc had significantly smaller cerebral and corpus callosum volumes than lSSc. Depression correlated with cerebral volume in dSSc (r=-0.31, p=0.03) and corpus callosum volume in both dSSc (r=-0.34, p=0.03) and lSSc (r=-0.30, p=0.04). Anxiety correlated with cerebral volume in dSSc (r=-0.30, p=0.02) and corpus callosum volume in both dSSc (r=-0.35, p=0.02) and lSSc (r=-0.26, p=0.04). MoCA scores correlated with corpus callosum volume in dSSc (r=0.57; p=0.002) and lSSc (r=0.29; p=0.04). No correlation was found between disease activity and cerebral volume (r=-0.05; p=0.14) or corpus callusum volume (r=-0.06; p=0.14).
Conclusion
dSSc have significant smaller cerebral and corpus callosum volumes when compared to lSSc and healthy controls. Structural abnormalities are observed in SSc patients with cognitive impairment and mood disorders. Disease activity and organ damage showed no correlation with cerebral volume and corpus callosum volume in this population.
Disclosure:
S. Dertkigil,
None;
T. N. Amaral,
None;
A. T. Lapa,
None;
F. Peres,
None;
R. Frittoli,
None;
A. P. del Rio,
None;
J. F. Marques-Neto,
None;
S. Appenzeller,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/reduction-of-cerebral-and-corpus-callosum-volume-in-systemic-sclerosis-a-volumetric-magnetic-resonance-imaging-study/