Childhood-onset lupus with clinical neurocognitive dysfunction shows lower streamline density and pairwise connectivity on diffusion tensor imaging

Abstract

Objectives To use diffusion tensor imaging (DTI) for investigating white matter connectivity changes associated with neurocognitive dysfunction in childhood-onset lupus (cSLE-NCD) as measured by formal neuropsychological testing. Methods DTI was performed in six subjects with (cSLE-NCD) and nine without neurocognitive dysfunction (cSLE-noNCD) as well as 14 healthy controls. Presence of neurocognitive deficits were identified by formal neuropsychological testing. The brain was divided into 116 regions, and pairwise connectivity (defined as the number of streamlines with an endpoint in each of those regions) and streamline density (defined as the number of streamlines passing through a region regardless of endpoints) were evaluated. Group comparisons were made for regional and global measures of streamline density and pairwise connectivity. Results A significant decrease in global streamline density was observed in the cSLE-NCD vs. control group (1189 vs. 1305 p = 0.002) and vs. cSLE-noNCD (1189 vs 1320 p= 0.001). The cSLE-noNCD and control groups had similar streamline density. A similar pattern for pairwise connectivity was observed with significant decrease in the cSLE-NCD group (217) versus the cSLE-noNCD (236; p=0.013) and control group (238; p=0.004). Regional measures of pairwise connectivity displayed mixed results. Conclusions The analysis of DTI in this pilot study shows cSLE-NCD is associated with global loss of streamline density and pairwise connectivity suggesting breakdown of the structural network. These results complement previously reported functional and volumetric findings that suggest cSLE-NCD is associated with measurable changes in gray and white matter. If confirmed in larger cohorts, DTI abnormalities could be used as imaging biomarkers of cSLE-NCD.

Relations between structural and EEG‐based graph metrics in healthy controls and schizophrenia patients

“…Similar connectomics analyses have been reported in schizophrenia (Di Biase et al, ) and other neurocognitive conditions (Jones et al, )…”

“…(Di Biase et al, 2017) and other neurocognitive conditions (Jones et al, 2015) 2.4 | EEG recordings and processing 2.4.1 | EEG acquisition and preprocessing EEG recordings were obtained following MRI scans, after a resting period of 30 min. Participants performed a 13 min three-tone P300 oddball task (for a detailed description see .…”

Magnetic Resonance Imaging in Neuropsychiatric Lupus

“…A localized injury of white matter tracts was also demonstrated in the limbic system, internal capsule, corpus callosum, forceps major and corona radiata 63, 66, 77, 79, 80 . Very recent publications underline the role of DTI as an imaging biomarker of NPSLE 81 .…”

Automatic Segmentation of the Corpus Callosum Using a Cell-Competition Algorithm

“…4,12-14 Some DTI results have further demonstrated that DTI-derived indices, such as fractional anisotropy (FA) and mean diffusivity (MD), correlate significantly with neuropsychological dysfunction, 15 and that fiber tracts abnormalities and pairwise connectivity are associated with clinical manifestations. 13,16,17 Therefore, an investigation of both volumetric changes and tissue alterations in the corpus callosum would help to understand the effects of CNS involvement in patients with SLE.Manual or semiautomatic segmentation approaches to volumetric measurement are time consuming, and the obtained segmentation results are likely to be error-prone and operator-dependent. 9 In contrast, automatic segmentation, which requires fewer inputs from operators and less processing time, would be more suitable for clinical applications.…”

“…4,[12][13][14] Some DTI results have further demonstrated that DTI-derived indices, such as fractional anisotropy (FA) and mean diffusivity (MD), correlate significantly with neuropsychological dysfunction, 15 and that fiber tracts abnormalities and pairwise connectivity are associated with clinical manifestations. 13,16,17 Therefore, an investigation of both volumetric changes and tissue alterations in the corpus callosum would help to understand the effects of CNS involvement in patients with SLE.…”