Yang Yifan, Zhao Ruotong, Zhang Fengrui, Bai Ru, Li Shu, Cui Ruomei, Liu Shuang, Xu Jian
Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Magnetic Resonance Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Front Neurosci. 2022 Aug 23;16:929383. doi: 10.3389/fnins.2022.929383. eCollection 2022.
Cognitive dysfunction (CI) is frequently reported in patients with systemic lupus erythematosus (SLE), but the identification and assessment of SLE-related CI remain challenging. Previous studies have focused on changes in static brain activity, and no studies have investigated the characteristics of dynamic brain activity in SLE patients with CI.
We calculated the dynamic amplitude of low-frequency fluctuation (dALFF) by combining the ALFF with a sliding window method to assess the temporal variability of brain functional activity in SLE patients with and without CI.
Thirty-eight SLE with CI, thirty-eight SLE without CI, and thirty-eight healthy controls (HCs) were recruited. By comparing static ALFF (sALFF) and dALFF among the three groups, changes in brain activity intensity and its temporal variability were assessed in patients with SLE with or without CI. Spearman correlation coefficients were calculated between the brain function indicator and Mini-mental State Examination (MMSE) scores of SLE with CI.
Subjects among the three groups exhibited significant sALFF differences in the right parahippocampal gyrus, left caudate nucleus, right putamen, and left cuneus. Compared to the SLE without CI, the right parahippocampal gyrus exhibited higher sALFF in the SLE with CI group. Compared to the HCs, the left caudate nucleus exhibited increased sALFF in the SLE with CI group. Participants in the three groups exhibited significant dALFF variability in the right parahippocampal gyrus, right lingual gyrus, and bilateral inferior occipital gyrus. Compared to the HCs, the right lingual gyrus exhibited reduced dALFF in the SLE without CI group. Compared to the HCs, the right parahippocampal gyrus exhibited increased dALFF, left calcarine fissure, and the surrounding cortex exhibited reduced dALFF in the SLE with CI group. There was no significant correlation between the MMSE score, sALFF, and dALFF in the SLE with CI group.
SLE patients with CI have abnormal brain activity intensity and stability. By analyzing the dynamics of intrinsic brain activity, it provides a new idea for evaluating SLE-related CI. However, more research and validation with multiple metrics are needed to determine the link between the severity of cognitive impairment (CI) and brain activity in patients with SLE.
认知功能障碍（CI）在系统性红斑狼疮（SLE）患者中经常被报道，但SLE相关CI的识别和评估仍然具有挑战性。以往的研究主要集中在静态脑活动的变化上，尚无研究探讨伴有CI的SLE患者动态脑活动的特征。
我们通过将低频振幅（ALFF）与滑动窗口方法相结合来计算动态低频振幅（dALFF），以评估伴有和不伴有CI的SLE患者脑功能活动的时间变异性。
招募了38例伴有CI的SLE患者、38例不伴有CI的SLE患者和38名健康对照者（HCs）。通过比较三组之间的静态ALFF（sALFF）和dALFF，评估伴有或不伴有CI的SLE患者脑活动强度及其时间变异性的变化。计算伴有CI的SLE患者脑功能指标与简易精神状态检查表（MMSE）评分之间的Spearman相关系数。
三组受试者在右侧海马旁回、左侧尾状核、右侧壳核和左侧楔叶的sALFF存在显著差异。与不伴有CI的SLE患者相比，伴有CI的SLE患者组右侧海马旁回的sALFF更高。与HCs相比，伴有CI的SLE患者组左侧尾状核的sALFF增加。三组受试者在右侧海马旁回、右侧舌回和双侧枕下回的dALFF存在显著变异性。与HCs相比，不伴有CI的SLE患者组右侧舌回的dALFF降低。与HCs相比，伴有CI的SLE患者组右侧海马旁回的dALFF增加，左侧距状裂及其周围皮质的dALFF降低。伴有CI的SLE患者组的MMSE评分、sALFF和dALFF之间无显著相关性。
伴有CI的SLE患者存在脑活动强度和稳定性异常。通过分析内在脑活动的动态变化，为评估SLE相关CI提供了新思路。然而，需要更多的研究和多指标验证来确定SLE患者认知障碍（CI）严重程度与脑活动之间的联系。
