The aim of this thesis was to investigate the pathofysiology of neuropsychiatric symptoms in the auto immune disease Systemic Lupus Erythematosus (SLE) using magnetic resonance imaging (MRI) of the... Show moreThe aim of this thesis was to investigate the pathofysiology of neuropsychiatric symptoms in the auto immune disease Systemic Lupus Erythematosus (SLE) using magnetic resonance imaging (MRI) of the brain. To this end MRI abnormalities in SLE patients with neuropsychiatric symptoms were compared with clinical symptoms and serological markers of disease. This thesis shows that immune abnormalities have an influence on the central nervous system in SLE (chapter 3&4). Reversible abnormalities in quantitative brain MRI in NPSLE are associated with clinical symptoms (chapter 2). These abnormalities are associated with neuroimaging features which may be interpreted as reversible axonal and/ or neuronal dysfunction (chapter 5). In line with this, severe ischemia does not appear to play a major role in NPSLE patients without obvious infarction on conventional MRI (chapter 6). Chapter 3 suggests that the influence of auto-immune antibodies is similar to the influence of auto-immune antibodies found in mouse models of NPLSE affecting specific locations of the brain. Using advanced MRI techniques and statistical analysis in chapter 7 suggests that the influence of auto-antibodies in human NPSLE also extends to white matter. Hopefully, these findings will facilitate earlier detection and treatment of neuropsychiatric symptoms in SLE. Show less
