Alterations in cerebral perfusion and corresponding brain functional networks in systemic lupus erythematosus with cognitive impairment.

Cognitive impairment (CI) frequently occurs in patients with systemic lupus erythematosus (SLE) and may result from neuroinflammation processes and neurovascular changes in the brain. The cerebral hemodynamics underlying SLE with CI (SLE-CI) remain unclear. 97 patients with SLE and 51 heathy controls (HCs) matched for age and gender underwent MRI. The CI status of patients was measured using the MoCA, and we classify those with a score of 28 or above as the SLE cognitive normal group (SLE-NC). 3D T1-weighted, ASL and resting-state functional (rs-fMRI) sequences were obtained. Seed-based functional connectivity (FC) was calculated using the cerebral blood flow (CBF) results. Compared with SLE-NC, patients with SLE-CI had higher CBF in the left hippocampus, thalamus, and cerebellum crus II and lower CBF in the left frontal lobe. Secondary analyses revealed that compared with patients with SLE-NC, patients with SLE-CI had increased FC of the left insula gyrus when the left cerebellum crus II was set as the seed region and decreased FC in the homolateral para-hippocampus when the left hippocampus was set as the seed region. These structural, functional, and network changes may serve as potential biomarkers for cognitive impairment in SLE-CI patients.