Nasreen Sultana1,2, Azmal Kabir Sarkar3, Hiroshi Matsuda4, Md Amimul Ihsan5, Syed Atiqul Haq6, Md Saidul Arefin2, Sheikh Nazrul Islam2. 1. Scintigraphy Division, National Institute of Nuclear Medicine and Allied Sciences, BSM Medical University Campus, Shahbag, Dhaka, 1000 Bangladesh. 2. Institute of Nutrition and Food Sciences, University of Dhaka, Dhaka, Bangladesh. 3. Institute of Nuclear Medicine & Allied Sciences (INMAS), Mitford, Sir Salimullah Medical College Campus, Dhaka, 1100 Bangladesh. 4. Department of Biofunctional Imaging, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295 Japan. 5. Department of Electrical and Electronic Engineering, Islamic University of Technology, Gazipur, Bangladesh. 6. Department of Rheumatology, BSM Medical University, Shahbag, Dhaka, 1000 Bangladesh.
Abstract
Purpose: Neuropsychiatric manifestation of lupus (NPSLE) is related with vitamin D (vit-D) deficiency which is possibly amenable to supplementation. This study was done to explore link of serum vit-D level and clinical mini-mental state examination (MMSE) with brain perfusion SPECT (BS) in patients with NPSLE. Methods: Patients who underwent BS with the diagnosis of NPSLE and had serum levels of vit-D and MMSE within a span of 1 month were retrospectively included. The BS DICOM data were used to generate 3D surface images of brain for visual identification of regional hypoperfusion, and the z-scores from eZIS software and then to perform voxel-based regression analysis in order to explore association between serum vit-D level and cerebral perfusion deficit using SPM8. Distribution of serum vit-D level was checked across MMSE and BS z-score using R. Results: A total 19 patients with means ± SD age of 28.4 ± 9.2 years, having mean levels of serum vit-D of 18.7 ± 9.8 ng/ml and mean MMSE scores 24.2 ± 1.6, had undergone BS. The eZIS-derived z-score fall in the category of normal in six (31.6%), mild perfusion deficit (PD) in 10 (52.6%) and moderate PD in three (15.8%) with the means ± SD of z-score being 0.52 ± 0.2, 1.72 ± 0.2, and 2.33 ± 0.2. Voxel-based analysis revealed significant positive correlation between vit-D level and hypoperfusion in brain regions related to cognitive function (p<0.05). Serum vit-D levels were significantly lower in NPSLE patients with lower MMSE scores as well as in higher eZIS z-score (p < 0.01). Conclusions: Our results may support the utility of vit-D supplementation in NPSLE and applicability of BS as a clinical adjunct for monitoring response to vit-D supplementation.
Purpose: Neuropsychiatric manifestation of lupus (NPSLE) is related with vitamin D (vit-D) deficiency which is possibly amenable to supplementation. This study was done to explore link of serum vit-D level and clinical mini-mental state examination (MMSE) with brain perfusion SPECT (BS) in patients with NPSLE. Methods: Patients who underwent BS with the diagnosis of NPSLE and had serum levels of vit-D and MMSE within a span of 1 month were retrospectively included. The BS DICOM data were used to generate 3D surface images of brain for visual identification of regional hypoperfusion, and the z-scores from eZIS software and then to perform voxel-based regression analysis in order to explore association between serum vit-D level and cerebral perfusion deficit using SPM8. Distribution of serum vit-D level was checked across MMSE and BS z-score using R. Results: A total 19 patients with means ± SD age of 28.4 ± 9.2 years, having mean levels of serum vit-D of 18.7 ± 9.8 ng/ml and mean MMSE scores 24.2 ± 1.6, had undergone BS. The eZIS-derived z-score fall in the category of normal in six (31.6%), mild perfusion deficit (PD) in 10 (52.6%) and moderate PD in three (15.8%) with the means ± SD of z-score being 0.52 ± 0.2, 1.72 ± 0.2, and 2.33 ± 0.2. Voxel-based analysis revealed significant positive correlation between vit-D level and hypoperfusion in brain regions related to cognitive function (p<0.05). Serum vit-D levels were significantly lower in NPSLE patients with lower MMSE scores as well as in higher eZIS z-score (p < 0.01). Conclusions: Our results may support the utility of vit-D supplementation in NPSLE and applicability of BS as a clinical adjunct for monitoring response to vit-D supplementation.
Authors: Caroline Gordon; Maame-Boatemaa Amissah-Arthur; Mary Gayed; Sue Brown; Ian N Bruce; David D'Cruz; Benjamin Empson; Bridget Griffiths; David Jayne; Munther Khamashta; Liz Lightstone; Peter Norton; Yvonne Norton; Karen Schreiber; David Isenberg Journal: Rheumatology (Oxford) Date: 2018-01-01 Impact factor: 7.580
Authors: K Waterloo; R Omdal; H Sjöholm; W Koldingsnes; E A Jacobsen; J A Sundsfjord; G Husby; S I Mellgren Journal: J Neurol Date: 2001-07 Impact factor: 4.849
Authors: E Papadaki; E Kavroulakis; G Bertsias; A Fanouriakis; D Karageorgou; P Sidiropoulos; E Papastefanakis; D T Boumpas; P Simos Journal: Lupus Date: 2019-11-13 Impact factor: 2.911
Authors: H Matsuda; S Mizumura; T Nagao; T Ota; T Iizuka; K Nemoto; N Takemura; H Arai; A Homma Journal: AJNR Am J Neuroradiol Date: 2007-04 Impact factor: 3.825