Advanced neuroimaging in systemic lupus erythematosus: identifying biomarkers for cognitive dysfunction

Area of Science:

• Neuroimaging
• Systemic Lupus Erythematosus (SLE)
• Cognitive Dysfunction (CD)

Background:

• Cognitive dysfunction (CD) is a frequent neurological complication in systemic lupus erythematosus (SLE).
• Early diagnosis of CD in SLE patients is challenging due to the lack of standardized diagnostic tests.
• This review explores advanced magnetic resonance imaging (MRI) applications for identifying neuroimaging biomarkers in SLE patients with CD.

Purpose of the Study:

• To review the current applications of various MRI techniques in SLE patients with CD.
• To identify potential quantitative neuroimaging biomarkers for SLE-associated CD.
• To highlight the role of advanced MRI in understanding the pathophysiology of CD in SLE.

Main Methods:

• Systematic literature search of databases from January 2003 to December 2024.
• Inclusion of retrospective and prospective studies evaluating advanced structural and functional MRI metrics in human SLE patients with CD.
• Keywords included: structural MRI, functional MRI, cognitive function, lupus, and systemic lupus erythematosus.

Main Results:

• 123 studies were identified, including Bold-MRI, DTI, ASL, MTI, and machine learning approaches.
• Abnormalities in the limbic system, hippocampus, corpus callosum, and frontal cortex were observed in SLE patients with CD, correlating with memory, attention, and executive functions.
• Multimodal MRI integrating structural, functional, and perfusion data, alongside machine learning, demonstrated effectiveness in predicting cognitive function.

Conclusions:

• Advanced MRI analysis reveals brain abnormalities associated with CD in SLE patients.
• Integrating machine learning with multimodal MRI offers novel approaches for early CD identification and mechanistic research in SLE.
• Further research is needed to establish reliable neuroimaging biomarkers for early diagnosis, treatment, and prognosis of CD in SLE.