The finding suggests that damage to the brain is apparent early in the course of disease, but the findings using these modalities are nonspecific. Functional MRI and other newer imaging modalities might prove to be better approaches to evaluating and following lupus patients with neuropsychiatric manifestations, she said.
For example, functional imaging is being used in an ongoing pilot study to help identify which networks are involved in the neuropsychiatric manifestations in lupus. Functional MRI is used to identify areas of increased oxygen metabolism after controls, patients with lupus and impaired cognition, and patients with lupus and normal cognition participate in a cognitive test involving spatial working memory.
“It's like a stress test for the brain,” Dr. Brey said, noting that functional MRI appears to be a useful tool in this setting.
The findings could eventually help to identify sources of pathology and surrogate end points for trials of treatments for neuropsychiatric manifestations of lupus, she said.