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Glymphatic dysfunction in systemic lupus erythematosus.

Xiaoran Ren1, Man Xu1, Yuan Huang1

  • 1Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450000, China.

Clinical Rheumatology
|March 2, 2026
PubMed
Summary
This summary is machine-generated.

Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) revealed impaired glymphatic system function in patients with systemic lupus erythematosus (SLE). The DTI-ALPS index may serve as a noninvasive biomarker for SLE, aiding in understanding its complex pathophysiology.

Keywords:
Diffusion tensor image analysis along the perivascular spaceGlymphatic systemMagnetic resonance imagingNeuroimaging biomarkersSystemic lupus erythematosus

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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.