Objectives The characteristics of brain impairment in different subtypes of systemic sclerosis (SSc) (dcSSc, diffuse cutaneous SSc; lcSSc, limited cutaneous SSc) remain unclear. This study aimed to characterize cerebral structure and perfusion changes in different subtype of SSc patients using magnetic resonance (MR) imaging. Methods Seventy SSc patients (46.0 ± 11.7 years, 62 females) and 30 healthy volunteers (44.8 ± 13.7 years, 24 females) were recruited and underwent brain MR imaging and Montreal Cognitive Assessment (MoCA) test. Gray matter (GM) volumes were measured using voxel-based morphometry analysis on T1-weighted images. Voxel-based and regional cerebral blood flow (CBF) was calculated on arterial spin labelling images. The cerebral structural and perfusion measurements by MR imaging were compared among dcSSc, lcSSc and healthy subjects using one-way ANOVA. The correlations between clinical characteristics and MR imaging measurements were also analyzed. Results The dcSSc patients exhibited a significant reduction in GM volume in the para-hippocampal region (cluster p < 0.01, FWE corrected) compared with healthy volunteers. Whereas, SSc patients, particularly lcSSc patients, showed elevated CBF in cerebellum, insula, cerebral cortex, and subcortical structures (regional analyses: all p < 0.05; voxel-based analyses: cluster p < 0.01, FWE corrected). Furthermore, clinical characteristics of modified Rodnan skin score (mRSS) (r value ranged from -0.29 to -0.45), MoCA scores (r = 0.40) and antinuclear antibody (ANA) positivity (r=-0.33) were significantly associated with CBF in some regions (all p < 0.05). Conclusion The manifestations of brain involvement vary among different subtypes of SSc. In addition, severe skin sclerosis may indicate higher risk of brain involvement in SSc patients.

中文翻译：

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系统性硬化症亚型脑结构和灌注的变化：脑磁共振成像研究


目的 系统性硬化症 (SSc) 不同亚型（dcSSc，弥漫性皮肤 SSc；lcSSc，局限性皮肤 SSc）的脑损伤特征仍不清楚。本研究旨在利用磁共振 (MR) 成像来表征不同亚型 SSc 患者的大脑结构和灌注变化。方法 招募 70 名 SSc 患者（46.0 ± 11.7 岁，62 名女性）和 30 名健康志愿者（44.8 ± 13.7 岁，24 名女性）进行脑部 MR 成像和蒙特利尔认知评估（MoCA）测试。使用基于体素的形态测量分析对 T1 加权图像测量灰质 (GM) 体积。根据动脉自旋标记图像计算基于体素的局部脑血流量 (CBF)。使用单向方差分析比较 dcSSc、lcSSc 和健康受试者的 MR 成像脑结构和灌注测量结果。还分析了临床特征和磁共振成像测量之间的相关性。结果 与健康志愿者相比，dcSSc 患者海马旁区域 GM 体积显着减少（簇 p < 0.01，FWE 校正）。然而，SSc 患者，特别是 lcSSc 患者，小脑、岛叶、大脑皮层和皮层下结构的 CBF 升高（区域分析：所有 p < 0.05；基于体素的分析：聚类 p < 0.01，FWE 校正）。此外，改良Rodnan皮肤评分（mRSS）（r值范围为-0.29至-0.45）、MoCA评分（r = 0.40）和抗核抗体（ANA）阳性（r = -0.33）的临床特征与CBF显着相关。一些地区（所有 p < 0.05）。结论 不同亚型的SSc脑部受累表现不同。 此外，严重的皮肤硬化可能表明 SSc 患者脑部受累的风险较高。