Neuroimaging Research Unit, INSPE, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Eur J Neurol. 2020 Jan;27(1):113-e2. doi: 10.1111/ene.14041. Epub 2019 Aug 8.
Systemic lupus erythematosus (SLE) is an immune-mediated disease that may affect the nervous system. We explored the topographical organization of structural and functional brain connectivity in patients with SLE and its correlation with neuropsychiatric (NP) involvement and autoantibody profiles.
Graph theoretical analysis was applied to diffusion tensor magnetic resonance imaging (MRI) and resting-state functional MRI data from 32 patients with SLE and 32 age- and sex-matched healthy controls. Structural and functional connectivity matrices between 116 cortical/subcortical brain regions were estimated using a bivariate correlation analysis, and global and nodal network metrics were calculated.
Structural, but not functional, global network properties (strength, transitivity, global efficiency and path length) were abnormal in patients with SLE versus controls (P < 0.0001), especially in patients with anti-double-stranded DNA (ADNA) autoantibodies (P = 0.03). No difference was found according to NP involvement or anti-phospholipid autoantibody status. Patients with SLE and controls shared identical structural hubs and the majority of functional hubs. In patients with SLE, all structural hubs showed reduced strength and clustering coefficient compared with controls (P from 0.001 to <0.0001), especially in patients with ADNA autoantibodies. Only a few differences in functional hub properties were found between patients with SLE and controls. Structural and functional hub measures did not differ according to NP involvement or anti-phospholipid autoantibody status. Significant correlations were found between clinical, MRI and network measures (r from -0.56 to 0.60, P from 0.0003 to 0.05).
Abnormalities of global and nodal structural connectivity occur in patients with SLE, especially with ADNA autoantibodies, with a diffuse disruption of structural integrity. Functional network integrity may contribute to preserve clinical functions.
系统性红斑狼疮（SLE）是一种可能影响神经系统的免疫介导性疾病。我们探讨了 SLE 患者脑结构和功能连接的拓扑组织及其与神经精神（NP）受累和自身抗体特征的相关性。
对 32 例 SLE 患者和 32 名年龄和性别匹配的健康对照者的弥散张量磁共振成像（MRI）和静息态功能 MRI 数据进行图论分析。采用双变量相关分析估计 116 个皮质/皮质下脑区之间的结构和功能连接矩阵，并计算全局和节点网络指标。
与对照组相比，SLE 患者的结构（而非功能）全局网络特性（强度、传递性、全局效率和路径长度）异常（P<0.0001），尤其是抗双链 DNA（ADNA）自身抗体阳性患者（P=0.03）。与 NP 受累或抗磷脂自身抗体状态无关。SLE 患者和对照组共享相同的结构枢纽和大部分功能枢纽。与对照组相比，SLE 患者的所有结构枢纽的强度和聚类系数均降低（P 值从 0.001 到<0.0001），尤其是 ADNA 自身抗体阳性患者。SLE 患者和对照组之间的功能枢纽特性差异较小。结构和功能枢纽指标与 NP 受累或抗磷脂自身抗体状态无关。临床、MRI 和网络指标之间存在显著相关性（r 值从-0.56 到 0.60，P 值从 0.0003 到 0.05）。
SLE 患者存在全局和节点结构连接异常，尤其是 ADNA 自身抗体阳性患者，其结构完整性受到广泛破坏。功能网络完整性可能有助于保持临床功能。
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