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

Shuang Liu,Zhongqi Xie,Aiyun Lai,Jian Xu,Yuqi Cheng,Yueyin Zhao,Zhaoping Lv,Hongjun Yu,Xiufeng Xu,Chunrong Luo,Baoci Shan,Lin Xu

doi:10.3389/fpsyt.2018.00677

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.

Highlights

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement and several typical autoantibodies
The age and gender were comparable between the systemic lupus erythematosus (SLE) and healthy controls (HC) group
The average head motion assessed by the mean framewise displacement (FD)_Jenkinson index between the two groups were comparable (0.0475 ± 0.0235 vs. 0.0547 ± 0.0273, p = 0.066) [6]

Summary

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiorgan involvement and several typical autoantibodies. Patients with neuropsychiatric signs and symptoms are classified as neuropsychiatric SLE (NPSLE) patients. In 1999, the American College of Rheumatology (ACR) defined 19 typical neuropsychiatric symptoms such as cerebrovascular disease (CVD), seizures, anxiety, and cognitive dysfunction [1]. While obvious NPSLE symptoms such as CVD and seizures are well-recognized by doctors, subtle ones such as rs-fMRI Study in Non-NPSLE Patients anxiety and mild cognitive dysfunction are underestimated. Detection and interventions are very important for those patients. Clinical psychiatric evaluations, such as the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD), are widely used in patients with anxiety and depressive disorders. Task-related fMRI and conscious resting state fMRI (rs-fMRI) are used to reveal different aspects of brain function

Methods

Results

Conclusion