White matter hyperintensities on brain magnetic resonance in systemic sclerosis

Objective—To evaluate the brain status of patients with systemic sclerosis (SSc). Methods—Fourteen female patients with SSc aged 24-74, with a disease duration of 1-12 years without other relevant systemic diseases were enrolled. All patients and an age-matched female control group (CG) of 14 clinically normal subjects, underwent brain magnetic resonance (MR) examination at 1.5 Tesla; spin-echo proton density-weighted images were evaluated. Mann-Whitney U and Spearman tests rank were used for statistical analysis. Results—One-hundred-seventy white matter hyperintensities ³2 mm in diameter were counted in the patients group (range 0–75, mean 12.1, median 4.5), only 13 in the CG (0–2, 0.9, 1, respectively), with a significant difference (p=0.011). Moreover, 208 <2-mm white matter hyperintensities were found in the patients group (0–38, 14.9, 8, respectively), only 31 in the CG (0–7, 2.0, 1, respectively), with a significant difference (p=0.006). No statistically significant correlation between the number of hyperintensities and both patient’s age and disease duration was observed. Conclusion—White matter hyperintensities are more frequent in SSc patients than in CG. These findings could be related to obliterative microvascular processes due to the disease. The hypothesis of an early brain involvement in SSc patients is suggested.