Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece.
Department of Psychiatry, University of Crete School of Medicine, Heraklion, Greece.
Lupus Sci Med. 2023 Jul;10(2). doi: 10.1136/lupus-2023-000920.
Τo determine whole-brain and regional functional connectivity (FC) characteristics of patients with neuropsychiatric SLE (NPSLE) or without neuropsychiatric manifestations (non-NPSLE) and examine their association with cognitive performance.
Cross-recurrence quantification analysis (CRQA) of resting-state functional MRI (rs-fMRI) data was performed in 44 patients with NPSLE, 20 patients without NPSLE and 35 healthy controls (HCs). Volumetric analysis of total brain and specific cortical and subcortical regions, where significant connectivity changes were identified, was performed. Cognitive status of patients with NPSLE was assessed by neuropsychological tests. Group comparisons on nodal FC, global network metrics and regional volumetrics were conducted, and associations with cognitive performance were estimated (at p<0.05 false discovery rate corrected).
FC in patients with NPSLE was characterised by increased modularity (mean (SD)=0.31 (0.06)) as compared with HCs (mean (SD)=0.27 (0.06); p=0.05), hypoconnectivity of the left (mean (SD)=0.06 (0.018)) and right hippocampi (mean (SD)=0.051 (0.0.16)), and of the right amygdala (mean (SD)=0.091 (0.039)), as compared with HCs (mean (SD)=0.075 (0.022), p=0.02; 0.065 (0.019), p=0.01; 0.14 (0.096), p=0.05, respectively). Hyperconnectivity of the left angular gyrus (NPSLE/HCs: mean (SD)=0.29 (0.26) and 0.10 (0.09); p=0.01), left (NPSLE/HCs: mean (SD)=0.16 (0.09) and 0.09 (0.05); p=0.01) and right superior parietal lobule (SPL) (NPSLE/HCs: mean (SD)=0.25 (0.19) and 0.13 (0.13), p=0.01) was noted in NPSLE versus HC groups. Among patients with NPSLE, verbal episodic memory scores were positively associated with connectivity (local efficiency) of the left hippocampus (r=0.22, p=0.005) and negatively with local efficiency of the left angular gyrus (r=0.24, p=0.003). Patients without NPSLE displayed hypoconnectivity of the right hippocampus (mean (SD)=0.056 (0.014)) and hyperconnectivity of the left angular gyrus (mean (SD)=0.25 (0.13)) and SPL (mean (SD)=0.17 (0.12)).
By using dynamic CRQA of the rs-fMRI data, distorted FC was found globally, as well as in medial temporal and parietal brain regions in patients with SLE, that correlated significantly and adversely with memory capacity in NPSLE. These results highlight the value of dynamic approaches to assessing impaired brain network function in patients with lupus with and without neuropsychiatric symptoms.
确定神经精神性狼疮（NPSLE）患者与无神经精神表现（非 NPSLE）患者的全脑和区域功能连接（FC）特征，并研究其与认知表现的关系。
对 44 例 NPSLE 患者、20 例无 NPSLE 患者和 35 例健康对照者（HCs）的静息态功能磁共振成像（rs-fMRI）数据进行交叉复现定量分析（CRQA）。对有显著连接变化的全脑和特定皮质及皮质下区域进行容积分析。对 NPSLE 患者的认知状态进行神经心理学测试评估。对节点 FC、全局网络指标和区域容积进行组间比较，并估计与认知表现的相关性（p<0.05 经假发现率校正）。
与 HCs 相比（平均值（SD）=0.27（0.06）），NPSLE 患者的 FC 表现为模块化增加（平均值（SD）=0.31（0.06）；p=0.05），左侧（平均值（SD）=0.06（0.018））和右侧海马（平均值（SD）=0.051（0.0.16））以及右侧杏仁核（平均值（SD）=0.091（0.039））的连接性降低，而与 HCs 相比（平均值（SD）=0.075（0.022），p=0.02；0.065（0.019），p=0.01；0.14（0.096），p=0.05）。与 HCs 组相比，NPSLE 患者的左侧角回（NPSLE/HCs：平均值（SD）=0.29（0.26）和 0.10（0.09）；p=0.01）、左侧（NPSLE/HCs：平均值（SD）=0.16（0.09）和 0.09（0.05）；p=0.01）和右侧顶叶上回（SPL）（NPSLE/HCs：平均值（SD）=0.25（0.19）和 0.13（0.13）；p=0.01）的连接性增加。在 NPSLE 患者中，言语性情节记忆评分与左侧海马（r=0.22，p=0.005）的连接（局部效率）呈正相关，与左侧角回的局部效率（r=0.24，p=0.003）呈负相关。无 NPSLE 的患者右侧海马（平均值（SD）=0.056（0.014））的连接性降低，左侧角回（平均值（SD）=0.25（0.13））和 SPL（平均值（SD）=0.17（0.12））的连接性增加。
通过使用 rs-fMRI 数据的动态 CRQA，我们发现 SLE 患者的全脑以及内侧颞叶和顶叶脑区存在连接扭曲，与 NPSLE 患者的记忆能力显著且不利相关。这些结果强调了动态方法在评估有和无神经精神症状的狼疮患者脑网络功能障碍方面的价值。
