Hippocampal Atrophy in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations

This study was conducted to explore hippocampal structural
changes and their possible associations with clinical characteristics,
emotional status and treatment
regimens in patients with systemic lupus erythematosus (SLE) without major
neuropsychiatric manifestations (non-NPSLE). Eighty-five non-NPSLE
patients with normal conventional magnetic resonance imaging (MRI) and seventy-seven
matched healthy control (HC) subjects were recruited. All participants underwent
the standard high-resolution volumetric MRI. Bilateral hippocampal volume (HIPV) and hippocampal
density (HIPD) were
calculated respectively for each participant. We found that the bilateral HIPV and HIPD of the
SLE patient group were significantly less than those of HC group. The bilateral HIPV of female patients
were significantly less than those of male patients. SLE disease activity
index (SLEDAI) was negatively correlated with the bilateral HIPV and the right HIPD.
Urine protein quantity was negatively correlated with the bilateral
HIPV and HIPD. Hydroxychloroquine (HCQ) showed a protective effect on right HIPV. In
conclusion, we found that the early hippocampal atrophy could occur before
obvious neuropsychiatric manifestations and might be associated with SLE
disease activity and organ damages. Early detection and intervention of hippocampal
damage might prevent the progression to NPSLE. More studies are needed to fully
understand the underlying mechanisms of hippocampal atrophy in SLE.