Tract-based white matter hyperintensity patterns in patients with systemic lupus erythematosus using an unsupervised...

Area of Science:

• Neuroimaging
• Neurology
• Medical image analysis

Background:

• White matter hyperintensities (WMH) are common in Systemic Lupus Erythematosus (SLE), but their spatial distribution and clinical significance remain poorly understood.
• Traditional markers like WMH count and volume do not account for the critical location of lesions within specific white matter tracts.

Purpose of the Study:

• To develop and validate a fully automated method for identifying predominant patterns of WMH distribution across white matter tracts in SLE patients.
• To investigate the consistency of these WMH patterns across different SLE subtypes and study sites.

Main Methods:

• Utilized cluster analysis on WMH segmentations from 221 SLE patients (with and without neuropsychiatric symptoms) across 20 white matter tracts.
• Employed automated WMH segmentation and lesion localization techniques.
• Validated findings for consistency across SLE subtypes and geographical sites.

Main Results:

• Identified five distinct clusters of WMH, predominantly affecting the forceps major, forceps minor, anterior thalamic radiations, and inferior fronto-occipital fasciculus.
• Demonstrated consistent tract-based WMH patterns across SLE subtypes and study sites.
• The automated pipeline successfully revealed robust and distinct spatial distributions of WMH.

Conclusions:

• The developed automated method effectively identifies specific white matter tract involvement in SLE patients.
• These tract-based WMH patterns are consistent and may serve as a basis for correlating lesion location with clinical symptoms.
• The approach holds potential for investigating the clinical relevance and pathomechanisms of WMH in SLE and other neurological diseases.