Abstract
ObjectiveThis study is aimed at investigating the characteristics of the spontaneous brain activity in inactive patients with nonneuropsychiatric systemic lupus erythematosus (non-NPSLE). Methods Thirty-one female inactive patients with non-NPSLE and twenty healthy controls were examined by resting-state functional magnetic resonance imaging (RS-fMRI). Three amplitude methods including amplitude of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and percent amplitude of fluctuation (PerAF) (with and without standardization) were applied to evaluate the spontaneous brain activity. The correlation was performed between low-frequency oscillations and clinical and neuropsychological factors in inactive patients with non-NPSLE. Results Compared to healthy controls, patients with non-NPSLE showed increased standardized ALFF (mALFF) in the left inferior temporal gyrus and left putamen, decreased PerAF in the right postcentral gyrus and bilateral precentral gyrus, and increased standardized PerAF (mPerAF) in the left putamen and decreased mPerAF in the right postcentral gyrus and bilateral precentral gyrus. By standardized fALFF (mfALFF), no significant brain regions were found between the two groups. Correlation analysis revealed significantly positive correlations between glucocorticoid dose and PerAF in the right precentral gyrus and mPerAF in the left putamen, and Complement 3 (C3) and mPerAF in the right postcentral gyrus. There was a significant negative correlation between C3 and mALFF in the left putamen. Conclusion Abnormal low-frequency oscillations in multiple brain regions were found in inactive patients with non-NPSLE, indicating that the alteration of mALFF, PerAF, and mPerAF in specific brain regions might be an imaging biomarker of brain dysfunction in inactive patients with non-NPSLE.
Highlights
Neuropsychiatric manifestations (NP) are common in patients with systemic lupus erythematosus (SLE) [1,2,3]
Decreased coupling between amplitude of low-frequency fluctuations (ALFF) and functional connectivity density (FCD) in bilateral hippocampus-parahippocampus was found in non-NPSLE patients in combination with ALFF and FCD together, and correlated with Complement 3 (C3), Complement 4 (C4), and Montreal Cognitive Assessment [17]
All non-NPSLE patients were in an inactive condition with SLE disease activity index (SLEDAI) < 5 and had no organ damage for more than 6 months
Summary
Neuropsychiatric manifestations (NP) are common in patients with systemic lupus erythematosus (SLE) [1,2,3]. Neuropsychological studies have found that SLE patients with nonneuropsychiatric systemic lupus erythematosus (non-NPSLE) can be affected with cognitive. Abnormal cortical thickness in the left lingual gyrus was found to be associated with increased resting-state functional connectivity of the left posterior cingulate cortex in nonNPSLE patients [13]. By both RS-fMRI and task-based fMRI, the abnormal functional connectivity of frontal-parietal was found to be associated with diseased activity in SLE patients [14]. Besides the abnormalities of functional connectivity, there is evidence of brain activity alteration in SLE patients. The brain activity in inactive patients with non-NPSLE remains elusive
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