Functional dysconnectivity and microstructural impairment of the cortico-thalamo-cortical network in women with rheumatoid arthritis: A multimodal MRI study
Yanmin Zheng,
Lei Xie,
Zikai Huang,
Jianhua Peng,
Shuxin Huang,
Ruiwei Guo,
Jinzhuang Huang,
Zhirong Lin,
Zelin Zhuang,
Jingjing Yin,
Zhiduo Hou,
Shuhua Ma
Affiliations
Yanmin Zheng
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Lei Xie
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Zikai Huang
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Jianhua Peng
Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Shuxin Huang
Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Ruiwei Guo
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Jinzhuang Huang
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Zhirong Lin
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Zelin Zhuang
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Jingjing Yin
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Zhiduo Hou
Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Corresponding author.
Shuhua Ma
Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Laboratory of Medical Molecular Imaging, The First Affiliated Hospital of Shantou University Medical College, Shantou, China; Corresponding author. Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Background: Cognitive deficits are common in rheumatoid arthritis (RA) patients, but the mechanisms remain unclear. We investigated the effective connectivity and structural alterations of the core brain regions in RA patients with cognitive impairment. Methods: Twenty-four female patients with RA and twenty-four healthy controls were enrolled. We analyzed abnormal brain activity patterns using functional MRI during the Iowa gambling task (IGT) and core regions effective connectivity using dynamic causal model (DCM). Structural alterations of white matter volume (WMV) and gray matter volume (GMV) were detected using voxel-based morphometry (VBM). Results: RA patients showed altered activation patterns of the cortico-thalamo-cortical network, increased coupling strength from the left ventromedial prefrontal gyrus to the anterior cingulate cortex (ACC), the ACC to the right thalamus, and decreased connectivity from the thalamus to left hippocampus. VBM structural analysis showed increased GMV in the bilateral orbital frontal gyrus, bilateral hippocampus and right putamen, and reduced GMV and WMV in the bilateral thalamus in RA patients. Right thalamic GMV and WMV were positively correlated with the right thalamus-to-hippocampus connective strength. Additionally, the bold signal, GMV and WMV of the right thalamus were positively correlated with cognitive performance (IGT score) in RA patients. Conclusion: Results suggest a structural and functional deficiency in the cortico-thalamo-cortical network, which is characterized by increased ACC-to-thalamus strength and reduced thalamus-to-hippocampus coupling in RA patients. The cognitive dysfunction may be the result of compensatory measures against imbalanced cortico-thalamic-cortical coupling.
