Cerebral white matter lesions in primary Sjogren's syndrome: A controlled study

Objective. To determine the prevalence of neurological and magnetic resonan ce imaging (MRI) abnormalities in a well defined population of unselected p atients with primary Sjogren's syndrome (SS) and age and sex matched health y patients. Methods, Thirty patients with SS and 29 age and sex matched controls were e xamined by a neurologist and subsequently underwent MRI scanning with a 1.0 Tesla Siemens Impact MR scanner. Scans were graded by a neuroradiologist b linded to the clinical status of each subject. The number and location of w hite matter lesions > 3 mm in long axis (to exclude non-specific perivascul ar changes) were recorded for each subject. Results, There was a significant increase in lesions detected by MRI in SS patients versus controls (p = 0.02) including deep white matter lesions (p = 0.03) and subcortical white matter lesions (p = 0.02). The presence of wh ite matter lesions did not correlate with serum IgG or rheumatoid factor le vels, or with presence of anticardiolipin antibodies. No subjects had sympt oms or signs of serious neurological disease including multiple sclerosis, and corpus callosal lesions commonly seen in multiple sclerosis were notabl y absent in this study. Conclusion. Cerebral white matter lesions detected by MRI are more frequent in patients with primary SS than control subjects, yet do not appear to be associated with significant clinical manifestations. Although the patholog ical nature of these lesions is yet to be defined, their presence should no t be over-interpreted.