Division of Rheumatology, Department of Medicine, University Medicine Cluster, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Semin Arthritis Rheum. 2012 Jun;41(6):849-58. doi: 10.1016/j.semarthrit.2011.11.010. Epub 2012 Jan 4.
To study the functional brain activation signals before and after sufficient disease control in patients with systemic lupus erythematosus (SLE) without clinical neuropsychiatric symptoms.
Blood-oxygen-level-dependent signals during event-related functional magnetic resonance imaging brain were recorded, while 14 new-onset SLE patients and 14 demographically and intelligence quotient matched healthy controls performed the computer-based Wisconsin card sorting test for assessing executive function, which probes strategic planning and goal-directed task performance during feedback evaluation (FE) and response selection (RS), respectively. Composite beta maps were constructed by a general linear model to identify regions of cortical activation. Blood-oxygen-level-dependent functional magnetic resonance imaging signals were compared between (1) new-onset SLE patients and healthy controls and (2) SLE patients before and after sufficient control of their disease activity.
During RS, SLE patients demonstrated significantly higher activation than healthy controls in both caudate bodies and Brodmann area (BA) 9 to enhance event anticipation, attention, and working memory, respectively, to compensate for the reduced activation during FE in BA6, 13, 24, and 32, which serve complex motor planning and decision-making, sensory integration, error detection, and conflict processing, respectively. Despite significant reduction of SLE activity, BA32 was activated during RS to compensate for reduced activation during FE in BA6, 9, 37, and 23/32, which serve motor planning, response inhibition and attention, color processing and word recognition, error detection, and conflict evaluation, respectively.
Even without clinically overt neuropsychiatric symptoms, SLE patients recruited additional pathways to execute goal-directed tasks to compensate for their reduced strategic planning skill despite clinically sufficient disease control.
研究无临床神经精神症状的系统性红斑狼疮（SLE）患者在充分控制疾病后大脑功能激活信号的变化。
采用事件相关功能磁共振成像记录血氧水平依赖信号，14 例新发 SLE 患者和 14 名年龄和智商匹配的健康对照者完成计算机威斯康星卡片分类测试，以评估执行功能，分别探测反馈评价（FE）和反应选择（RS）期间的策略规划和目标导向任务表现。通过一般线性模型构建复合β图来识别皮质激活区域。比较（1）新发 SLE 患者和健康对照组，（2）SLE 患者疾病活动充分控制前后的血氧水平依赖功能磁共振成像信号。
在 RS 期间，SLE 患者的尾状核体和 Brodmann 区（BA）9 的激活显著高于健康对照组，分别增强事件预期、注意力和工作记忆，以补偿 BA6、13、24 和 32 中的 FE 期间的激活减少，这些区域分别用于复杂的运动规划和决策、感觉整合、错误检测和冲突处理。尽管 SLE 活动显著减少，但在 RS 期间 BA32 被激活，以补偿 BA6、9、37 和 23/32 中的 FE 期间的激活减少，这些区域分别用于运动规划、反应抑制和注意力、颜色处理和单词识别、错误检测和冲突评估。
即使没有明显的临床神经精神症状，SLE 患者在充分控制疾病后仍会招募额外的途径来执行目标导向任务，以弥补其策略规划技能的下降。
