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Lupus nephritis (LN) carries high morbidity and mortality and whenever added to neuropsychiatric manifestations lead to more unfavorable prognosis. Though silent brain MRI findings in systemic lupus erythematosus (SLE) had been widely studied, the current work focused on LN patients comparing them to those without kidney affection, studying their cerebral MRI and its correlation with the histopathological classes of LN and disease activity. This may enable us to know more about early brain affection in LN patients for better follow up, management, and prognosis of this serious comorbidity. Cerebral MRI and MRA were studied in 40 SLE patients without neuropsychiatric manifestations; 20 LN patients with different histopathological classes and 20 patients without kidney affection. Disease activity was assessed for all patients using SLE disease activity index (SLEDAI). Abnormal MRI brain findings were more common in LN patients “though non significant” (P = 0.9). The most common lesions were white matter hyperintense lesions (WMHLs). Number and size of such lesions were significantly higher in LN patients (1.8 fold that of non nephritis, P = 0.003 and 0.03, respectively) and positively correlated with urea, creatinine, urinary albumin/creatinine ratio, SLEDAI, ESR, CRP, and grades of renal biopsy and negatively correlated with C3 and C4. Cortical atrophy and prepontine space dilatation were also significantly higher in LN patients (P = 0.01). Asymptomatic MRI brain lesions whenever present in LN patients, they are usually clinically significant and well correlate to laboratory parameters of LN, grades of renal biopsy, and disease activity independent to age, sex and hypertension.

The relation of white matter hyperintense lesions to episodic memory impairment in patients with Parkinson's disease (PD) is still controversial. We aimed at evaluating the relation between white matter hyperintense lesions and episodic memory decline in patients with PD. In this multicentric prospective study, twenty-one normal controls, 15 PD patients without mild cognitive impairment (MCI) and 13 PD patients with MCI were selected to conduct a clinico-radiological correlation analysis. Performance during episodic memory testing, age-related white matter changes score, total manual and automated white matter hyperintense lesions volume and lobar white matter hyperintense lesions volumes were compared between groups using the Kruskal-Wallis and Wilcoxon signed-rank tests, and correlations were assessed using the Spearman test. MCI PD patients had impaired free recall. They also had higher total, left prefrontal and left temporal white matter hyperintense lesions volumes than normal controls. Free recall performance was negatively correlated with the total white matter hyperintense lesions volume, either manually or automatically delineated, but not with the age-related white matter changes score. Using automated segmentation, both the left prefrontal and temporal white matter hyperintense lesions volumes were negatively correlated with the free recall performance. Early episodic memory impairment in MCI PD patients may be related to white matter hyperintense lesions, mainly in the prefrontal and temporal lobes. This relation is influenced by the method used for white matter hyperintense lesions quantification. Automated volumetry allows for detecting those changes. [ABSTRACT FROM AUTHOR]

Lupus nephritis (LN) carries high morbidity and mortality and whenever added to neuropsychiatric manifestations lead to more unfavorable prognosis. Though silent brain MRI findings in systemic lupus erythematosus (SLE) had been widely studied, the current work focused on LN patients comparing them to those without kidney affection, studying their cerebral MRI and its correlation with the histopathological classes of LN and disease activity. This may enable us to know more about early brain affection in LN patients for better follow up, management, and prognosis of this serious comorbidity. Cerebral MRI and MRA were studied in 40 SLE patients without neuropsychiatric manifestations; 20 LN patients with different histopathological classes and 20 patients without kidney affection. Disease activity was assessed for all patients using SLE disease activity index (SLEDAI). Abnormal MRI brain findings were more common in LN patients “though non significant” ( P  = 0.9). The most common lesions were white matter hyperintense lesions (WMHLs). Number and size of such lesions were significantly higher in LN patients (1.8 fold that of non nephritis, P  = 0.003 and 0.03, respectively) and positively correlated with urea, creatinine, urinary albumin/creatinine ratio, SLEDAI, ESR, CRP, and grades of renal biopsy and negatively correlated with C3 and C4. Cortical atrophy and prepontine space dilatation were also significantly higher in LN patients ( P  = 0.01). Asymptomatic MRI brain lesions whenever present in LN patients, they are usually clinically significant and well correlate to laboratory parameters of LN, grades of renal biopsy, and disease activity independent to age, sex and hypertension. [ABSTRACT FROM AUTHOR]