Impaired decision-making and functional neuronal network activity in systemic lupus erythematosus

Area of Science:

• Neuroimaging
• Cognitive Neuroscience
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is linked to cognitive deficits, but the underlying neural mechanisms are not fully understood.
• Investigating brain activity in SLE patients without overt neuropsychiatric symptoms is crucial for understanding disease impact.

Purpose of the Study:

• To examine brain activity patterns during decision-making in SLE patients using functional magnetic resonance imaging (fMRI).
• To determine if clinical markers correlate with brain involvement in SLE.

Main Methods:

• fMRI was used to record brain activity in 16 female SLE patients and 16 healthy controls during the Iowa Gambling Task (IGT).
• BOLD signal changes were analyzed to compare brain activation between groups.
• Statistical analyses included t-tests, ANOVA, and linear regression.

Main Results:

• Both groups exhibited activation in a distributed brain network, including prefrontal cortex, cingulate cortex, and striatum.
• SLE patients displayed reduced activation in the orbitofrontal cortex, ventromedial prefrontal cortex, anterior cingulate cortex, and posterior cingulate cortex compared to controls.
• SLE patients showed increased activation in the dorsolateral prefrontal cortex, insular cortex, and striatum.
• Ventromedial prefrontal cortex activation correlated positively with IGT scores and negatively with disease activity.

Conclusions:

• Altered brain activity dynamics in SLE patients may explain underlying pathological mechanisms, even without overt neuropsychiatric symptoms.
• Disease activity could serve as a biomarker for cerebral involvement in SLE.