Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

Abstract

To investigate core resting state networks in SLE patients with and without neuropsychiatric symptoms by examining functional connectivity changes correlating with results of cognitive testing. Structural MRI and resting state‐fMRI (rs‐fMRI) were performed in 61 female SLE patients (mean age: 36.8 years, range 18.2–52.0 years) and 20 healthy controls (HC) (mean age 36.2 years, range 23.3–52.2 years) in conjunction with clinical examination and cognitive testing. Alterations in core resting state networks, not found in our healthy controls sample, correlated with cognitive performance gauged by neuropsychological tests in non‐neuropsychiatric SLE (nNP) as well as in neuropsychiatric SLE patients (NP). The observed pattern of increased functional connectivity in core resting state networks correlated with reduced cognitive performance on all cognitive domains tested and with a heavy focus on DM, CE, and DM–CE in the NP subgroup. Furthermore, we found that the observed alterations in memory and psychomotor speed correlated with disease duration. In SLE patients both with and without clinically overt neuropsychiatric manifestations, we found changes in the functional connectivity of core resting state networks essential to cognitive functions. These findings may represent a rewiring of functional architecture in response to neuronal damage and could indicate suboptimal compensatory mechanisms at play.

Altered Amplitude of Low-Frequency Fluctuations in Inactive Patients with Nonneuropsychiatric Systemic Lupus Erythematosus

“…The prevalence of fatigue ranges from 76% to 100% in active or inactive SLE patients [62–64], so we thought fatigue is a common symptom of systemic lupus erythematosus. Previous studies found that patients with SLE had significantly higher scores of FSS compared to healthy controls, which is consistent with our study [12, 64–66]. We will carry out relevant researches in the future.…”

Altered Functional Brain Network in Systemic Lupus Erythematosus Patients Without Overt Neuropsychiatric Symptoms Based on Resting-State Functional Magnetic Resonance Imaging and Multivariate Pattern Analysis

“…SMG is a portion of the inferior parietal lobe ( 37 ), whereas the dorsolateral MFG and IFG mainly belong to the dorsolateral prefrontal cortex ( 43 ). Hyperconnectivity was found between the hippocampus with the inferior parietal lobe, INS, and dorsolateral prefrontal cortex in this study, which parallels the previous research ( 14 ). Integrated research on non-NPSLE patients utilized diffusion tensor imaging, and fluorine-18 fluorodeoxyglucose positron emission tomography approaches found that the patients had compromised microstructural integrity in clusters that contained the HIP, frontal and parietal lobe ( 44 ).…”

“…Brain network anomaly has been previously explored in non-NPSLE. Using the independent component analysis method, Nystedt et al ( 14 ) found the increased functional connectivity (FC) within the default mode network (DMN) and central executive network and in-between these two sub-networks in non-NPSLE. Another study detected altered FC within the DMN, salient network, central executive network, and working-memory network ( 15 ).…”

Cognitive dysfunction in autoimmune rheumatic diseases

“…There is evidence to suggest that SLE patients, with and without overt NPSLE, have aberrations in their white matter microstructures as seen by diffusion tensor imaging (DTI) [36]. Functional MRI studies have shown increased functional connectivity in core resting-state networks in SLE patients that correlate with reduced cognitive performance compared with healthy controls [37]. FDG-PET imaging highlighted hypermetabolic regions that corresponded with increased serum anti-NMDAR antibodies in SLE patients with CD and did not correlate with disease duration, activity, medications or comorbidities [26,27].…”