Analysis of local spontaneous neuronal activity by resting ⁃ state functional MRI in patients with neuropsychiatric systemic lupus erythematosus

Abstract

Objective To investigate the changes of neural function and its correlation with cognitive function and emotion in patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods A total of 46 patients with systemic lupus erythematosus (SLE) admitted to The Affiliated Taizhou People's Hospital of Nanjing Medical University from June 2020 to September 2022 were included. The patients were divided into the NPSLE group (n = 26) and the non⁃NPSLE group (n = 20) based on the presenceor absence of neuropsychiatric symptoms. The mean regional homogeneity (mReHo) and mean fractional amplitude of low⁃frequency fluctuation (mfALFF) were calculated by resting⁃state fMRI (rs⁃fMRI). The Mini⁃Mental State Examination (MMSE) was used to evaluate overall cognitive function, the Fatigue Scale for Motor and Cognitive Functions (FSMC) was used to assess both motor and cognitive fatigue, and the Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression mood. Pearson correlation analysis and partial correlation analysis were conducted to explore the correlation of mReHo and mfALFF values in various brain regions with neuropsychologcial tests. Results The MMSE scores in NPSLE group was lower than non⁃NPSLE group (Z = ⁃ 3.934, P = 0.000). Additionally, the FSMC⁃ Motor (t = 2.016, P = 0.050), FSMC⁃Cognition (t = 2.055, P = 0.046), HADS⁃Anxiety (Z = ⁃ 2.424, P = 0.015) and HADS⁃Depression (Z = ⁃ 2.731, P = 0.006) scores in NPSLE group were higher than those in non⁃NPSLE group. The mReHo values of the right dorsolateral superior frontal gyrus, right middle occipital gyrus, right posterior central gyrus, right inferior parietal margin angular gyrus and right inferior temporal gyrus decreased, while mfALFF values of the right middle occipital gyrus and right posterior central gyrus decreased in the NPSLE group (false discovery rate correction; voxel level P < 0.001, cluster P < 0.05). The mReHo and mfALFF in the right postcentral gyrus were both negatively correlated with HADS⁃Depression (r = ⁃ 0.483, P = 0.017; r = ⁃ 0.504, P = 0.012). The mReHo in the right inferior parietal gyrus was negatively correlated with FSMC ⁃Motor (r = ⁃ 0.475, P = 0.019) and FSMC ⁃Cognition (r = ⁃ 0.414, P = 0.044). The mReHo in the right inferior temporal gyrus was negatively correlated with FSMC⁃Cognition (r = ⁃ 0.427, P = 0.037). Conclusions NPSLE patients exhibited abnormal local activity in brain regions, and neural function is closely related to neuropsychological test.

Keywords

• lupus vasculitis, central nervous system
• magnetic resonance imaging
• neuropsychological tests