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The following is a summary of “Changes of cerebral structure and perfusion in subtypes of systemic sclerosis: a brain magnetic resonance imaging study,” published in the August 2024 issue of Rheumatology by Tong et al.
The specifics of brain impairment across different systemic sclerosis (SSc) subtypes (dcSSc, diffuse cutaneous SSc, lcSSc, limited cutaneous SSc) still need to be fully understood.
Researchers conducted a retrospective study using magnetic resonance imaging (MRI) to identify changes in cerebral structure and perfusion among SSc subtypes.
They included 70 patients with SSc (mean age 46.0 ± 11.7 years, 62 females) and 30 HCs (mean age 44.8 ± 13.7 years, 24 females) for brain MRI and Montreal Cognitive Assessment (MoCA) testing. Gray matter (GM) volumes were assessed using voxel-based morphometry on T1-weighted images, while voxel-based and regional cerebral blood flow (CBF) was measured using arterial spin labeling images. Comparisons of cerebral structure and perfusion among dcSSc, lcSSc, and HCs were performed using one-way ANOVA, and correlations between clinical characteristics and MRI measurements were also examined.
The result showed a significant decrease in the GM volume of patients with dcSSc in the para-hippocampal region compared to HCs (cluster p < 0.01, FWE corrected). In contrast, patients with SSc, especially patients with lcSSc, exhibited increased CBF in the cerebellum, insula, cerebral cortex, and subcortical structures (regional analyses: all P<0.05; voxel-based analyses: cluster P<0.01, FWE corrected). Additionally, clinical characteristics, such as the modified Rodnan skin score (mRSS) (r values from -0.29 to -0.45), MoCA scores (r = 0.40), and antinuclear antibody (ANA) positivity (r=-0.33), were significantly correlated with CBF in specific brain regions (all P<0.05).
Investigators concluded that brain involvement in SSc varies by subtype and that severe skin sclerosis may be associated with an increased risk of cerebral involvement.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae404/7727678
