A Conscious Resting State fMRI Study in SLE Patients Without Major Neuropsychiatric Manifestations

Abstract

Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the main causes of death in patients with systemic lupus erythematosus (SLE). Signs and symptoms of NPSLE are heterogeneous, and it is hard to diagnose, and treat NPSLE patients in the early stage. We conducted this study to explore the possible brain activity changes using resting state functional magnetic resonance imaging (rs-fMRI) in SLE patients without major neuropsychiatric manifestations (non-NPSLE patients). We also tried to investigate the possible associations among brain activity, disease activity, depression, and anxiety. In our study, 118 non-NPSLE patients and 81 healthy controls (HC) were recruited. Rs-fMRI data were used to calculate the regional homogeneity (ReHo) in all participants. We found decreased ReHo values in the fusiform gyrus and thalamus and increased ReHo values in the parahippocampal gyrus and uncus. The disease activity was positively correlated with ReHo values of the cerebellum and negatively correlated with values in the frontal gyrus. Several brain areas showed correlations with depressive and anxiety statuses. These results suggested that abnormal brain activities might occur before NPSLE and might be the foundation of anxiety and depression symptoms. Early detection and proper treatment of brain dysfunction might prevent the progression to NPSLE. More studies are needed to understand the complicated underlying mechanisms.

Cognitive Dysfunction in Systemic Lupus Erythematosus: A Case for Initiating Trials

“…Conventional MRI studies reveal decreased hippocampal volumes in SLE patients with CD compared to those without CD (10). One study demonstrated decreased activation of the hippocampus/parahippocampal gyrus on functional MRI during a spatial working memory task in SLE patients (11), and another study showed abnormal regional activity in the parahippocampal gyrus on functional MRI during the resting state (12). This is of interest, as multiple lines of evidence in rodent models indicate that hippocampal integrity is critical for spatial memory (13).…”

Altered Temporal Dynamics of Brain Activity in Multiple-Frequency Bands in Non-Neuropsychiatric Systemic Lupus Erythematosus Patients with Inactive Disease

“…Several previous studies reported that static ReHo was altered in non-NPSLE patients. 14 , 33 Specifically, active patients with SLE showed decreased ReHo in the right fusiform gyrus and increased ReHo in the left parahippocampal and right uncus. 14 , 33 However, static ReHo can only reflect static local brain activity.…”

“…For example, researchers found increased standardized ALFF in the left inferior temporal gyrus and left putamen in patients with non-NPSLE and the significantly negative correlation between C3 and ALFF values in the left putamen was found in patients. 13 Liu et al 14 found abnormal ReHo in the parahippocampal gyrus, fusiform gyrus, and thalamus in non-NPSLE patients and ReHo values in the left postcentral gyrus were negatively correlated with anxiety depression symptoms. Yu et al 15 found decreased ALFF in the precuneus and increased ALFF in the right cuneus and right calcarine fissure surrounding cortex in non-NPSLE patients.…”

“… 31 , 32 Researchers observed the abnormal brain activity in SLE patients was associated with the disease activity. 14 , 33–35 Previous RS-fMRI studies mainly focused on non-NPSLE patients with active disease but a lack of studies in non-NPSLE patients with inactive disease. To address these issues, we sought to investigate the temporal variability of brain activity in non-NPSLE patients with inactive disease using dReHo and dfALFF in typical band (0.01–0.08 Hz), slow-4 (0.027–0.073 Hz), and slow-5 (0.01–0.027 Hz).…”

Using the Mouse to Model Human Diseases: Cognitive Impairment in Systemic Lupus Erythematosus

“…The advantage of fMRI is its ability to detect variations in the deoxyhemoglobin levels in neurons as a measure of neuronal activity, serving as an indirect assessment of cerebral functions such as working memory, executive function, and attention 34 . Different studies demonstrated abnormalities in the hippocampal/parahippocampal regions of patients with SLE both at rest and during a memory task 35,36 .…”