Association between microscopic brain damage as indicated by magnetization transfer imaging and anticardiolipin antibodies in neuropsychiatric lupus

Table 1 Patient characteristics, NPSLE manifestations and abnormalities detected on conventional MRI

Age (years)	Neuropsychiatric symptoms^a	IgM aCLs	IgG aCLs	Lac	Anti-dsDNA	Anti-ENA	Radiological abnormalities
23	Acute confusional state	-	-	-	+	+	NDA
24	Primary generalized tonic clonic seizures	+	+	+	-	-	NDA
25	Primary generalized absence seizures	+	+	+	-	-	PAIS (6 lesions, 4 mm) cerebral atrophy
26	Primary generalized absence seizures	-	+	-	-	+	NDA
27	Primary generalized tonic clonic seizures	+	+	+	+	+	NDA
27	Primary generalized tonic clonic seizures	-	-	+	-	+	NDA
29	Cerebrovascular disease^b	+	-	+	-	NA	NDA
30	Anxiety disorder	-	-	-	-	+	NDA
30	Cognitive dysfunction	-	+	+	-	+	NDA
30	Aseptic meningitis	-	-	-	-	+	NDA
32	Cerebrovascular disease^b	+	+	+	NA	-	PAIS (29 lesions, 6 mm) cerebral atrophy, cerebellar infarction (9 mm)
36	Cerebrovascular disease^b; cognitive dysfunction	-	-	+	-	-	NDA
38	Primary generalized tonic clonic seizures	+	+	+	-	-	PAIS (2 lesions, 6 mm) cerebral atrophy, cerebellar infarction (9 mm)
39	Aseptic meningitis	+	+	+	-	+	NDA
41	Chorea	-	-	+	+	+	PAIS (7 lesions, 4 mm)
41	Mononeuropathy (single); cognitive dysfunction	-	+	+	+	+	PAIS (1 lesion, 7 mm)
49	Mood disorder with depressive features	+	-	-	-	-	PAIS (21 lesions, 3 mm)
65	Cerebrovascular disease^b	+	-	+	-	+	CAIS

^aAccording to the American College of Rheumatology (ACR) nomenclature and case definitions for neuropsychiatric lupus syndromes [2]. ^bChronic multifocal disease. aCL, anticardiolipin antibody; anti-dsDNA, antibodies directed agains double stranded DNA; anti-ENA, antibodies directed against extractable nuclear antigen; Lac, lupus anticoagulant; MRI, magnetic resonance imaging; NA, not available; NDA, no detectable abnormalities on conventional MRI; CAIS/PAIS, confluent and punctate areas of increased signal (number of lesions, mean size of lesions); NPSLE, neuropsychiatric systemic lupus erythematosus.

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