by Steven G. Pavlakis, M.D., Darren
R. Gitelman, M.D., Rima G. Kopelman, M.D. and Isak Prohovnik, PhD.
Published: 6 June 1996
Neurological complication of systemic lupus erythematosus (SLE) may be
associated with abnormal cortical blood flow. We tested whether a
technique for measuring cortical blood flow might provide useful
information about the extent and nature of encephalopathy in
SLE. Cortical perfusion was quantified in eighteen SLE patients by
the xenon-133 regional cerebral blood flow (rCBF) technique. Vasomotor
reactivity, thought to reflect vascular-reserve capacity was
quantified by hypercapnic challenge in sixteen of the eighteen
patients. Perfusion and reactivity were compared with groups of
healthy controls and patients with major depression. Compared with
sex and age matched controls, cortical blood flow was
lower in female SLE patents (73mL/100 g/min vs 90 mL/100 g/min, p <
.02). Cerebrovascular reserve, as measured by hypercapnic reactivity,
was abnormally low in the SLE group (.57%/mmHg vs 3.35%/mmHg in
depressed controls, p < .02) and negative in neurologically
affected patients and those on steroids (rCBF decreased after
hypercapnic challenge). We conclude that cerebrovascular dysfunction
is common in SLE, and abnormal vascular reactivity is associated with
neurologic symptoms and steroid treatment. Further longitudinal
studies and larger samples are necessary to define the sensitivity and
specificity of this finding.
Key words: cerebral circulation, systemic lupus erythematosus,
xenon-133, hypercapnia.
Cortical Blood Flow and Reactivity in Systematic Lupus Erythematosus
(1:3)
by Steven Pavlakis, M.D. et al.
