Objectives To determine hippocampal and amigdala abnormalities in systemic sclerosis (SSc) and to determine the possible relationship with clinical, laboratory and treatment features of the disease.
Methods A total of 41 SSc patients and sixty-six health age and sex matched volunteers. A complete clinical, laboratory and neurological evaluation was performed in all subjects. Cognitive evaluation was performed in all participants using the Montreal Cognitive Assessment (MoCA). Mood disorders were determined through Beck's Depression and Beck's Anxiety Inventories. SSc patients were further assessed for disease activity (Valentini Activity Index), severity activity (Medsger Severity Index) and current drug exposure. MRI scans were performed in a 3T Phillips® scanner. Coronal T1 weighted were used for manual volumetric measurements.
Results We included 27 (65.9%) limited SSc (lSSc) and 14 (34.1%) diffuse SSc (dSSc) with mean disease duration of 10.4 (SD 6.9) years. Active disease was identified in 12 (29.3%) SSc patients. Abnormal neurological examination was observed in 27 (65.8%) and cognitive impairment in 36 (87.8%) SSc patients. Mood disorders were identified in 25 (60.9%) SSc patients. In dSSc, hippocampal (mean volume =2.95 cm3;; SD=0.13) and amigdala (mean volume =1.81 cm3;; SD=0.09) were significantly smaller when compared to hippocampal (mean volume =3.19 cm3;; SD=0.08; p=0.03) and amigdala (mean volume =2.12 cm3;; SD=0.09 p=0.02) volumes of lSSc and to hippocampal (mean volume =3.26 cm3;; SD=0.09; p=0.03) and amigdala (mean volume =2.15 cm3;; SD=0.10; p=0.02) volumes of healthy volunteers. No difference between hippocampal (p=0.08) and amigdala (p=0.12) volumes of lSSC and healthy controls were observed. Depression correlated with left hippocampal volume in dSSc (r=-0.51, p=0.003). No correlation between depression and amigdala volumes was observed. Anxiety correlated with hippocampal volume in dSSc (r=-0.38; p=0.03) and with amigdala volume in both dSSc (r=-0.29, p=0.04) and lSSc (r=-0.28, p=0.04).MoCA scores correlated with hippocampal volume in dSSc (r=0.44; p=0.03) and lSSc (r=0.32; p=0.04) and with amigdala volume in dSSc (r=0.36; p=0.04) and lSSc (r=0.35; p=0.03). No correlation was found between disease activity and hippocampal volume (r=-0.06; p=0.16) or amigdala volume (r=-0.09; p=0.19). No association was found between organic impairment and hippocampal volume (r=-0.05; p=0.11) or amigdala volume (r=-0.04; p=0.12).
Conclusions This is the first study to analyze hippocampal and amigdala volume in SSc. We observed significant reduced hippocampal and amigdala volumes in dSSc when compared to lSSc and healthy volunteers. Hippocampal and amigdala volumes correlated with cognitive impairment and mood disorders in SSc.
Disclosure of Interest None declared