Fatigue and cognitive function in systemic lupus erythematosus: associations with white matter microstructural...

Area of Science:

• Neuroscience
• Rheumatology
• Medical Imaging

Background:

• Systemic lupus erythematosus (SLE) is associated with neurological complications, including fatigue and cognitive impairment.
• The underlying neuropathological mechanisms in SLE, particularly white matter microstructural changes, require further investigation.

Purpose of the Study:

• To investigate the relationship between fatigue, cognitive function, and diffuse white matter microstructural brain damage in patients with SLE.
• To explore the association of these factors with SLE activity, clinical data, and plasma biomarkers.

Main Methods:

• Diffusion tensor magnetic resonance imaging (MRI) was used to assess brain white matter integrity in 51 SLE patients and age-matched controls.
• Fatigue and cognitive function were evaluated and correlated with SLE disease parameters and inflammatory biomarkers.
• A meta-analysis of 10 studies was conducted to confirm findings on white matter integrity in SLE.

Main Results:

• SLE patients showed significantly higher mean diffusivity (MD) in all white matter tracts compared to controls, indicating microstructural damage.
• Increased fatigue in SLE was associated with lower MD, depression, anxiety, and higher body mass index.
• Poorer cognitive function correlated with longer SLE duration and higher IL-6 levels, but not with MD.

Conclusions:

• Patients with SLE have greater age-related microstructural brain white matter damage than the general population.
• This brain damage does not appear to be the primary driver of increased fatigue or lower cognition in SLE.
• The association between elevated IL-6 and impaired cognitive function in SLE warrants further investigation in larger cohorts.