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Yan J, Li Z, Wills M, Rajah G, Wang X, Bai Y, Dong P, Zhao X. Intracranial microembolic signals might be a potential risk factor for cognitive impairment. Neurol Res 2021; 43:867-873. [PMID: 34409926 DOI: 10.1080/01616412.2021.1939488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: We aimed to explore the relationship between microembolic signals (MES) and cognitive impairment in patients with neurological disorders using a 30-minute MES monitoring test.Methods: We retrospectively reviewed patients who visited outpatient departments and underwent a 30-minute MES monitoring session using dual-channel transcranial doppler (TCD) at Beijing Tiantan hospital between July 2016 and December 2018. All patients completed the Montreal Cognitive Assessment (MoCA) and underwent magnetic resonance imaging (MRI). Cognitive impairment was defined as a MoCA score of less than 26. MES were identified according to the criteria of the International Consensus Group on Microembolus Detection.Results: Of the 1356 subjects who underwent MES monitoring, 159 patients (including 50 cases of MES positive and 109 cases of MES negative) had both analyzable MES monitoring recording and cognition evaluation data, of which 72 had cognitive impairment. Compared with the group with no deficits in cognitive function, the proportion of MES positive was significantly higher in patients with impaired cognitive function - that is, 47% (34/72) versus 18.4% (16/87), respectively, with p < 0.05. In multivariate logistic regression analysis, MES were independently associated with lower MoCA score (odd ratios (OR), 7.36; 95% confidence intervals (CI), 2.72-19.85, P < 0.0001).Conclusions: In this retrospective study, we found a possible correlation and relationship between MES and cognitive impairment. Further studies are required to determine whether continuous cerebral microembolization to the brain will lead to progressive cognitive impairment.
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Affiliation(s)
- Jing Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Zhaoxia Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Melissa Wills
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Gary Rajah
- Department of Neurosurgery, Munson Medical Center, Traverse City, MI, USA
| | - Xin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yaqiu Bai
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Pei Dong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of neurology, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of neurology, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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The neurology of lupus. J Neurol Sci 2021; 424:117419. [PMID: 33832774 DOI: 10.1016/j.jns.2021.117419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/30/2020] [Accepted: 03/24/2021] [Indexed: 12/19/2022]
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Kargiotis O, Psychogios K, Safouris A, Magoufis G, Zervas PD, Stamboulis E, Tsivgoulis G. The Role of Transcranial Doppler Monitoring in Patients with Multi‐Territory Acute Embolic Strokes: A Review. J Neuroimaging 2019; 29:309-322. [DOI: 10.1111/jon.12602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
| | | | - Apostolos Safouris
- Stroke UnitMetropolitan Hospital Piraeus Greece
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
| | | | - Paschalis D. Zervas
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
| | | | - Georgios Tsivgoulis
- Second Department of NeurologyNational & Kapodistiran University of Athens, School of Medicine, “Attikon” University Hospital Athens Greece
- Department of NeurologyThe University of Tennessee Health Science Center Memphis TN
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Amanat M, Thijs RD, Salehi M, Sander JW. Seizures as a clinical manifestation in somatic autoimmune disorders. Seizure 2019; 64:59-64. [DOI: 10.1016/j.seizure.2018.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/10/2018] [Accepted: 11/22/2018] [Indexed: 02/07/2023] Open
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5
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Bortoluzzi A, Padovan M, Azzini C, De Vito A, Trotta F, Govoni M. Brain unidentified bright objects (“UBO”) in systemic lupus erythematosus: sometimes they come back. A study of microembolism by cMRI and Transcranial Doppler ultrasound. Lupus 2015; 25:193-8. [DOI: 10.1177/0961203315608256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/26/2015] [Indexed: 11/16/2022]
Abstract
Objectives The objectives of this report are to assess the occurrence of microembolic signals (MES) detected by transcranial Doppler ultrasound (TCD) in systemic lupus erythematosus (SLE) patients with (NPSLE) and without (SLE) neuropsychiatric involvement, and to verify the correlation between MES, clinical characteristics, especially the patent foramen ovale (PFO), and the presence of punctuate T2-hyperintense white matter lesions (WMHLs) detected by conventional magnetic resonance imaging (cMRI). Methods A TCD registration to detect MES from the middle cerebral artery was carried out in SLE and NPSLE patients after exclusion of aortic and/or carotid atheromatous disease. In all patients conventional brain magnetic resonance imaging (cMRI) and transesophageal echocardiography were performed. Patients were stratified in two groups, with and without WMHLs, and compared. Results Twenty-three SLE patients (16 NPSLE and seven SLE) were enrolled in the study. Overall MES were detected in 12 patients (52.1%), WHMLs were detectable in 15 patients (13 NPSLE and two SLE) while eight patients had normal cMRI (three NPSLE and five SLE). Matching TCD ultrasound and neuroimaging data, MES were detected in 10 (nine NPSLE and one SLE) out of 15 patients with WHMLs and in only two out of eight patients (two NPSLE and six SLE) with normal cMRI, both with NP involvement. A PFO was confirmed in all cases of MES detection. Conclusion MES are frequent findings in SLE patients, especially in those with focal WMHLs detected by cMRI and correlating with PFO. These findings should be taken into account and suggest caution in the interpretation of cMRI pictures along with a careful evaluation of MES in patients with cMRI abnormalities that should be included in the workup of SLE patients.
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Affiliation(s)
- A Bortoluzzi
- Department of Medical Science, Section of Rheumatology, University of Ferrara and Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
| | - M Padovan
- Department of Medical Science, Section of Rheumatology, University of Ferrara and Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
| | - C Azzini
- Department of Neuroscience, Section of Neurology, Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
| | - A De Vito
- Department of Neuroscience, Section of Neurology, Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
| | - F Trotta
- Department of Medical Science, Section of Rheumatology, University of Ferrara and Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
| | - M Govoni
- Department of Medical Science, Section of Rheumatology, University of Ferrara and Azienda Ospedaliero Universitaria Sant’Anna di Cona, Ferrara, Italy
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Abstract
Introduction:Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.Methods and Materials:Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.Results:MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).Conclusions:MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.
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Jablonowski R, Wilson MW, Do L, Hetts SW, Saeed M. Multidetector CT measurement of myocardial extracellular volume in acute patchy and contiguous infarction: validation with microscopic measurement. Radiology 2014; 274:370-8. [PMID: 25247406 DOI: 10.1148/radiol.14140131] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To provide proof of concept that expansion of myocardial extracellular volume (MECV), measured at contrast material-enhanced multidetector computed tomography (CT), can be used as a (a) marker for viability based on histologic confirmation and (b) predictor of severity of myocardial injury. MATERIALS AND METHODS Animals cared for in compliance with Institutional Animal Care and Use Committee served as controls (group 1, n = 6) or were subjected to microinfarction by using 16-mm(3) (60 000 count) microemboli (group 2) and 32-mm(3) (120 000 count) microemboli (group 3), contiguous infarct with left anterior descending artery (LAD) occlusion followed by reperfusion (group 4), or the combination of LAD occlusion and 32-mm(3) microemboli followed by reperfusion (group 5) (n = 7 per group). MECV calculations were based on regional measurements of signal attenuation at contrast-enhanced multidetector CT and counterstaining of infarct at microscopy. Two-way analysis of variance and Student t tests were used to determine significant differences (P < .05). Data were presented as means ± standard deviations. RESULTS Mean signal attenuation at equilibrium state of contrast media distribution (10 minutes) was significantly different among blood (137 HU ± 10), myocardial muscle (77 HU ± 12, P < .05), and skeletal muscle (35 HU ± 12, P < .05). Patchy microinfarct, contiguous infarct, and microinfarct with preexisting contiguous infarct can be differentiated on the basis of mean MECV (24% ± 3 [group 1] vs 36% ± 3 [group 2], P < .01, and 55% ± 5 [group 4], 56% ± 4 [group 5] vs 41% ± 3 [group 3], P < .05). Microscopy measurements confirmed multidetector CT quantitative measurements and differences in patterns of infarct caused by obstruction of major and minor coronary arteries. Regression analysis revealed excellent correlation between regional MECV using multidetector CT and microscopy (r(2) = 0.92). CONCLUSION Contrast-enhanced multidetector CT is a suitable noninvasive imaging technique for assessing MECV in acute patchy and contiguous infarct caused by obstruction of major and minor coronary vessels.
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Affiliation(s)
- Robert Jablonowski
- From the Department of Radiology and Biomedical Imaging, School of Medicine, University of California-San Francisco, 185 Berry St, Suite 350, Campus Box 0946, San Francisco, CA 94107-5705
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Zardi EM, Taccone A, Marigliano B, Margiotta DP, Afeltra A. Neuropsychiatric systemic lupus erythematosus: Tools for the diagnosis. Autoimmun Rev 2014; 13:831-9. [DOI: 10.1016/j.autrev.2014.04.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/30/2014] [Indexed: 01/18/2023]
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Deschamps I, Tremblay P. Sequencing at the syllabic and supra-syllabic levels during speech perception: an fMRI study. Front Hum Neurosci 2014; 8:492. [PMID: 25071521 PMCID: PMC4086203 DOI: 10.3389/fnhum.2014.00492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/17/2014] [Indexed: 11/13/2022] Open
Abstract
The processing of fluent speech involves complex computational steps that begin with the segmentation of the continuous flow of speech sounds into syllables and words. One question that naturally arises pertains to the type of syllabic information that speech processes act upon. Here, we used functional magnetic resonance imaging to profile regions, using a combination of whole-brain and exploratory anatomical region-of-interest (ROI) approaches, that were sensitive to syllabic information during speech perception by parametrically manipulating syllabic complexity along two dimensions: (1) individual syllable complexity, and (2) sequence complexity (supra-syllabic). We manipulated the complexity of the syllable by using the simplest syllable template—a consonant and vowel (CV)-and inserting an additional consonant to create a complex onset (CCV). The supra-syllabic complexity was manipulated by creating sequences composed of the same syllable repeated six times (e.g., /pa-pa-pa-pa-pa-pa/) and sequences of three different syllables each repeated twice (e.g., /pa-ta-ka-pa-ta-ka/). This parametrical design allowed us to identify brain regions sensitive to (1) syllabic complexity independent of supra-syllabic complexity, (2) supra-syllabic complexity independent of syllabic complexity and, (3) both syllabic and supra-syllabic complexity. High-resolution scans were acquired for 15 healthy adults. An exploratory anatomical ROI analysis of the supratemporal plane (STP) identified bilateral regions within the anterior two-third of the planum temporale, the primary auditory cortices as well as the anterior two-third of the superior temporal gyrus that showed different patterns of sensitivity to syllabic and supra-syllabic information. These findings demonstrate that during passive listening of syllable sequences, sublexical information is processed automatically, and sensitivity to syllabic and supra-syllabic information is localized almost exclusively within the STP.
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Affiliation(s)
- Isabelle Deschamps
- Département de Réadaptation, Université Laval Québec City, QC, Canada ; Centre de recherche de l'Institut universitaire en santé mentale de Québec Québec City, QC, Canada
| | - Pascale Tremblay
- Département de Réadaptation, Université Laval Québec City, QC, Canada ; Centre de recherche de l'Institut universitaire en santé mentale de Québec Québec City, QC, Canada
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Libman-Sacks endocarditis and embolic cerebrovascular disease. JACC Cardiovasc Imaging 2014; 6:973-83. [PMID: 24029368 DOI: 10.1016/j.jcmg.2013.04.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 04/18/2013] [Accepted: 04/23/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether Libman-Sacks endocarditis is a pathogenic factor for cerebrovascular disease (CVD) in systemic lupus erythematosus (SLE). BACKGROUND A cardioembolic pathogenesis of SLE CVD manifested as: 1) neuropsychiatric systemic lupus erythematosus (NPSLE), including stroke and transient ischemic attacks (TIA); 2) neurocognitive dysfunction; and 3) magnetic resonance imaging of focal brain lesions has not been established. METHODS A 6-year study of 30 patients with acute NPSLE (27 women, 38 ± 12 years of age), 46 age- and sex-matched SLE controls without NPSLE (42 women, 36 ± 12 years of age), and 26 age- and sex-matched healthy controls (22 women, 34 ± 11 years of age) who underwent clinical and laboratory evaluations, transesophageal echocardiography, carotid duplex ultrasound, transcranial Doppler ultrasound, neurocognitive testing, and brain magnetic resonance imaging/magnetic resonance angiography. Patients with NPSLE were re-evaluated after 4.5 months of therapy. All patients were followed clinically for a median of 52 months. RESULTS Libman-Sacks vegetations (87%), cerebromicroembolism (27% with 2.5 times more events per hour), neurocognitive dysfunction (60%), and cerebral infarcts (47%) were more common in NPSLE than in SLE (28%, 20%, 33%, and 0%) and healthy controls (8%, 0%, 4%, and 0%, respectively) (all p ≤ 0.009). Patients with vegetations had 3 times more cerebromicroemboli per hour, lower cerebral blood flow, more strokes/TIA and overall NPSLE events, neurocognitive dysfunction, cerebral infarcts, and brain lesion load than those without (all p ≤ 0.01). Libman-Sacks vegetations were independent risk factors of NPSLE (odds ratio [OR]: 13.4; p < 0.001), neurocognitive dysfunction (OR: 8.0; p = 0.01), brain lesions (OR: 5.6; p = 0.004), and all 3 outcomes combined (OR: 7.5; p < 0.001). Follow-up re-evaluations in 18 of 23 (78%) surviving patients with NPSLE demonstrated improvement of vegetations, microembolism, brain perfusion, neurocognitive dysfunction, and lesion load (all p ≤ 0.04). Finally, patients with vegetations had reduced event-free survival time to stroke/TIA, cognitive disability, or death (p = 0.007). CONCLUSIONS The presence of Libman-Sacks endocarditis in patients with SLE was associated with a higher risk for embolic CVD. This suggests that Libman-Sacks endocarditis may be a source of cerebral emboli.
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Cantú-Brito C, Baizabal-Carvallo JF, Alonso-Juárez M, García-Ramos G. The clinical significance of microembolic signals in patients with systemic lupus erythematosus. Neurol Res 2013; 32:134-8. [DOI: 10.1179/016164109x12478302362699] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Tremblay P, Baroni M, Hasson U. Processing of speech and non-speech sounds in the supratemporal plane: auditory input preference does not predict sensitivity to statistical structure. Neuroimage 2012; 66:318-32. [PMID: 23116815 DOI: 10.1016/j.neuroimage.2012.10.055] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 08/27/2012] [Accepted: 10/15/2012] [Indexed: 11/17/2022] Open
Abstract
The supratemporal plane contains several functionally heterogeneous subregions that respond strongly to speech. Much of the prior work on the issue of speech processing in the supratemporal plane has focused on neural responses to single speech vs. non-speech sounds rather than focusing on higher-level computations that are required to process more complex auditory sequences. Here we examined how information is integrated over time for speech and non-speech sounds by quantifying the BOLD fMRI response to stochastic (non-deterministic) sequences of speech and non-speech naturalistic sounds that varied in their statistical structure (from random to highly structured sequences) during passive listening. Behaviorally, the participants were accurate in segmenting speech and non-speech sequences, though they were more accurate for speech. Several supratemporal regions showed increased activation magnitude for speech sequences (preference), but, importantly, this did not predict sensitivity to statistical structure: (i) several areas showing a speech preference were sensitive to statistical structure in both speech and non-speech sequences, and (ii) several regions that responded to both speech and non-speech sounds showed distinct responses to statistical structure in speech and non-speech sequences. While the behavioral findings highlight the tight relation between statistical structure and segmentation processes, the neuroimaging results suggest that the supratemporal plane mediates complex statistical processing for both speech and non-speech sequences and emphasize the importance of studying the neurocomputations associated with auditory sequence processing. These findings identify new partitions of functionally distinct areas in the supratemporal plane that cannot be evoked by single stimuli. The findings demonstrate the importance of going beyond input preference to examine the neural computations implemented in the superior temporal plane.
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Affiliation(s)
- P Tremblay
- Université Laval, Rehabilitation Department, Québec City, Qc., Canada; Centre de Recherche de l'Institut Universitaire en santé mentale de Québec (CRIUSMQ), Québec City, Qc., Canada.
| | - M Baroni
- Center for Mind/Brain Sciences (CIMeC), University of Trento, via delle Regole, 1010, 38060, Mattarello (TN), Italy; Department of Information Science, University of Trento, via delle Regole, 1010, 38060, Mattarello (TN), Italy
| | - U Hasson
- Center for Mind/Brain Sciences (CIMeC), University of Trento, via delle Regole, 1010, 38060, Mattarello (TN), Italy; Department of Psychology and Cognitive Sciences, University of Trento, via delle Regole, 1010, 38060, Mattarello (TN), Italy
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Kapadia M, Sakic B. Autoimmune and inflammatory mechanisms of CNS damage. Prog Neurobiol 2011; 95:301-33. [DOI: 10.1016/j.pneurobio.2011.08.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 08/18/2011] [Accepted: 08/19/2011] [Indexed: 12/13/2022]
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Microembolic signals in systemic lupus erythematosus and other cerebral small vessel diseases. J Neurol 2009; 257:503-8. [DOI: 10.1007/s00415-009-5421-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 11/29/2009] [Accepted: 12/02/2009] [Indexed: 11/25/2022]
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Baizabal-Carvallo JF, Cantú-Brito C, García-Ramos G. Acute Neurolupus Manifested by Seizures Is Associated with High Frequency of Abnormal Cerebral Blood Flow Velocities. Cerebrovasc Dis 2008; 25:348-54. [DOI: 10.1159/000118381] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 10/17/2007] [Indexed: 11/19/2022] Open
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Zhang YX, Liu JR, Ding MP, Huang J, Zhang M, Jansen O, Deuschl G, Eschenfelder CC. Reversible posterior encephalopathy syndrome in systemic lupus erythematosus and lupus nephritis. Intern Med 2008; 47:867-75. [PMID: 18451582 DOI: 10.2169/internalmedicine.47.0741] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Reversible posterior encephalopathy syndrome (RPES) is a clinical entity characterized with headache, nausea, vomiting, seizures, consciousness disturbance, and frequently visual disorders associated with neuroradiological findings, predominantly white matter abnormalities of the parieto-occipital lobes. The central nervous system manifestations of systemic lupus erythematosus (SLE) are highly diverse. However, SLE-associated RPES has been seldom reported. Here, we report a case with RPES in SLE and lupus nephritis with exclusive involvement of parietal and occipital cortices. A systematic review of the literature on the pathogenesis and treatment of SLE-associated RPES is included.
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Affiliation(s)
- Yan-Xing Zhang
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, PR China
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