Glymphatic dysfunction in systemic lupus erythematosus

Area of Science:

• Neuroimaging
• Systemic Lupus Erythematosus Research
• Glymphatic System Function

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with potential neurological involvement.
• Neuropsychiatric SLE (NPSLE) presents diagnostic challenges, and underlying mechanisms require further elucidation.
• The glymphatic system plays a crucial role in waste clearance in the brain, and its dysfunction is implicated in various neurological conditions.

Purpose of the Study:

• To evaluate glymphatic system activity in NPSLE and non-NPSLE patients using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
• To explore the correlation between the DTI-ALPS index and clinical indicators in SLE patients.
• To establish DTI-ALPS as a potential noninvasive imaging biomarker for SLE.

Main Methods:

• Recruitment of 33 healthy controls (HC), 33 non-NPSLE patients, and 13 NPSLE patients.
• Acquisition of diffusion tensor imaging (DTI) data to calculate the DTI-ALPS index at the lateral ventricle body.
• Statistical analysis including one-way ANOVA and Pearson/Spearman correlation to compare DTI-ALPS index across groups and with clinical indicators.

Main Results:

• The DTI-ALPS index was significantly reduced in the total SLE group, as well as in both NPSLE and non-NPSLE subgroups, compared to HC.
• A significant difference in the DTI-ALPS index was observed among four SLE patient grades based on SLEDAI scores.
• No significant correlations were found between the DTI-ALPS index and clinical indicators such as serum C3, C4, CH50, anti-Smith antibodies, or SLEDAI scores.

Conclusions:

• The DTI-ALPS index is a potential noninvasive imaging biomarker for assessing glymphatic system function in non-NPSLE and NPSLE patients.
• Impaired glymphatic system function may be a contributing factor to the pathophysiology of SLE.
• These findings enhance the understanding of SLE's underlying mechanisms through neuroimaging.