Central Nervous System Involvement in Primary Sjögren’s Syndrome: Narrative Review of MRI Findings
László V. Módis,
Zsófia Aradi,
Ildikó Fanny Horváth,
János Bencze,
Tamás Papp,
Miklós Emri,
Ervin Berényi,
Antal Bugán,
Antónia Szántó
Affiliations
László V. Módis
Department of Behavioural Sciences, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
Zsófia Aradi
Division of Clinical Immunology, Department of Internal Medicine, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
Ildikó Fanny Horváth
Division of Clinical Immunology, Department of Internal Medicine, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
János Bencze
Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of General Medicine, University of Debrecen, Nagyerdei körút 98, HU-4032 Debrecen, Hungary
Tamás Papp
Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of General Medicine, University of Debrecen, Nagyerdei körút 98, HU-4032 Debrecen, Hungary
Miklós Emri
Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of General Medicine, University of Debrecen, Nagyerdei körút 98, HU-4032 Debrecen, Hungary
Ervin Berényi
Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of General Medicine, University of Debrecen, Nagyerdei körút 98, HU-4032 Debrecen, Hungary
Antal Bugán
Department of Behavioural Sciences, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
Antónia Szántó
Division of Clinical Immunology, Department of Internal Medicine, Faculty of General Medicine, University of Debrecen, Móricz Zsigmond krt. 22, HU-4032 Debrecen, Hungary
Central nervous system (CNS) involvement is one of the numerous extraglandular manifestations of primary Sjögren’s syndrome (pSS). Moreover, neurological complaints precede the sicca symptoms in 25–60% of the cases. We review the magnetic resonance imaging (MRI) lesions typical for pSS, involving the conventional examination, volumetric and morphometric studies, diffusion tensor imaging (DTI) and resting-state fMRI. The most common radiological lesions in pSS are white matter hyperintensities (WMH), scattered alterations hyperlucent on T2 and FLAIR sequences, typically located periventricularly and subcortically. Cortical atrophy and ventricular dilatation can also occur in pSS. Whilst these conditions are thought to be more common in pSS than healthy controls, DTI and resting-state fMRI alterations demonstrate evident microstructural changes in pSS. As pSS is often accompanied by cognitive symptoms, these MRI alterations are expectedly related to them. This relationship is not clearly delineated in conventional MRI studies, but DTI and resting-state fMRI examinations show more convincing correlations. In conclusion, the CNS manifestations of pSS do not follow a certain pattern. As the link between the MRI lesions and clinical manifestations is not well established, more studies involving larger populations should be performed to elucidate the correlations.
