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Metabolic and microstructural alterations in the SLE brain correlate with cognitive impairment
Meggan Mackay1, An Vo2, Chris C Tang2
1Autoimmune, Musculoskeletal and Hematopoietic Diseases and.
JCI Insight
|January 11, 2019
Summary
Systemic lupus erythematosus (SLE) patients show brain hypermetabolism and white matter damage linked to cognitive dysfunction. These stable neuroimaging markers may aid early SLE-associated cognitive dysfunction detection.
Area of Science:
- Neuroimaging
- Autoimmune Diseases
- Cognitive Science
Background:
- Diagnosing cognitive dysfunction (CD) in systemic lupus erythematosus (SLE) is challenging due to autoimmune mechanisms.
- Differentiating SLE-associated CD from confounding factors requires advanced diagnostic tools.
Purpose of the Study:
- To identify reliable neuroimaging markers for SLE-associated cognitive dysfunction.
- To correlate neuroimaging findings with cognitive performance and autoantibody levels.
Main Methods:
- Utilized resting-state functional FDG-PET and diffusion tensor imaging (DTI) in adult SLE patients with quiescent disease.
- Conducted cognitive testing and analyzed serum DNRAb titers.
- Assessed neuroimaging markers and cognitive performance over 15 months.
Main Results:
- Identified resting hypermetabolism in sensorimotor, occipital, and temporal lobes, hippocampus, orbitofrontal cortex, and basal ganglia/thalamus.
- Observed abnormal interregional metabolic correlations linked to impaired cognition, stable over 15 months.
- Found decreased white matter integrity in tracts near hypermetabolic regions, correlating with impaired spatial memory and higher DNRAb titers.
Conclusions:
- Regional hypermetabolism and decreased microstructural integrity are reproducible, stable markers for SLE-associated CD.
- These markers are independent of disease duration, activity, medication, or comorbidities.
- Findings suggest potential for early disease detection, group discrimination, and treatment response assessment.
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