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Published on: May 16, 2025
Fronto-cerebellar features associate with cognitive dysfunction in childhood-onset systemic lupus erythematosus
Hanne Van der Heijden1, Gabrielle Alonzi2, Amanda Cao1
1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA USA.
Childhood-onset systemic lupus erythematosus (cSLE) patients show impaired cognitive function linked to fronto-cerebellar abnormalities. This study highlights brain differences in cSLE, impacting cognitive flexibility and working memory.
Area of Science:
- Neuroscience
- Immunology
- Pediatrics
Background:
- Cognitive dysfunction (CD) is common in childhood-onset systemic lupus erythematosus (cSLE).
- Understanding the neurobehavioral basis of CD in cSLE is crucial for effective management.
Purpose of the Study:
- To investigate the neurobehavioral underpinnings of cognitive dysfunction in pediatric patients with systemic lupus erythematosus.
- To identify neuroimaging correlates of cognitive deficits in cSLE.
Main Methods:
- 20 cSLE patients and 20 healthy controls (HCs) underwent neurocognitive testing, questionnaires, and neuroimaging (fNIRS, fMRI, structural MRI).
- Clinical status was monitored using Systemic Lupus Erythematosus Disease Activity Index 2000 and laboratory markers.
- K-means clustering was used to identify subgroups within the cSLE cohort based on neuroimaging profiles.
Main Results:
- cSLE patients exhibited worse cognitive functioning, higher emotional distress, and more physical symptoms compared to HCs.
- Neuroimaging revealed altered prefrontal cortex and frontal cortex/cerebellum activity during cognitive tasks, and impaired fronto-cerebellar connectivity.
- Reduced gray matter in frontal and cerebellar regions and altered white matter connectivity were observed in cSLE patients.
Conclusions:
- Fronto-cerebellar abnormalities are associated with cognitive dysfunction in childhood-onset systemic lupus erythematosus.
- These findings emphasize the need for multidisciplinary research to understand the neurobiology of CD in cSLE.
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