PROTON MAGNETIC-RESONANCE SPECTROSCOPY OF SYSTEMIC LUPUS-ERYTHEMATOSUS INVOLVING THE CENTRAL-NERVOUS-SYSTEM

We examined 13 patients with neurological manifestations of systemic l upus erythematosus (SLE) based on previous and/or current neurological or psychotic episodes by magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) together with psychiatric and co gnitive assessment. MRI was abnormal in 7 patients, showing high signa l lesions in the white matter and/or cerebral atrophy. Proton MRS cent red on white matter lesions in 5 patients showed a reduction in the N- acetyl aspartate creatine ratio compared with normal appearing white m atter in the SLE group and in 10 healthy controls. This pattern of abn ormality does not allow differentiation of SLE lesions from the chroni c plaques occurring in multiple sclerosis. There was a very high incid ence of current psychiatric morbidity in the SLE group, namely in 12 o f the 13 patients. There was no correlation between the presence of cu rrent psychiatric involvement and/or cognitive dysfunction and abnorma lities detected with MRI or MRS.