Application Of Resting-state Functional Magnetic Resonace Imaging In Neuropsychiatric Systemic Lupus Erythematosus

Background:Neuropsychiatric systemic lupus erythematosus (NPSLE)is the common complication of systemic lupus erythematosus (SLE) and represents an important cause of morbidity and mortality in patients with SLE. The diagnosis of NPSLE is difficult due to complicted clinical presentations. Studies have shown that funtional damage resides prior to organic lesions and even neuropsychiatric symptoms.Objective:to find evidence for early diagnosis of NPSLE by using resting-state fMRI in NPSLE patients and high risk SLE patients with out neuropsychiatric symptoms(HRSLE).Methods:11NPSLE patients,9SLE patients with anti-ribosoprotein P antibody or anti-phospholipid antibody or retinal vasculopathy and without neuropsychiatric symptoms, and12health control(HC) were enrolled, and performed resting-state fMRI scanning. Data were processed and analysed by SPM8software package, then post processed with methods called regional homogeneity(ReHo), fractional amplitude low-frequency fluctuation(fALFF) and graph theoretical analysis, respectively. ReHo maps, fALFF maps, and degree central ity (DC) maps were got and the difference of ReHo values, fALFF values, DC values between every two groups of NPSLE, HRSLE and HC were compared by independent t test to find functional altered areas of the brain.Results:NPSLE and HRSLE subjects displayed significantly decreased ReHo values in areas of inferior parietal lobules, left inferior temporal gyrus, left medial superior frontal gyrus, and left postcentral gyrus, compared to HCs (P＜0.01), among which, left supramarginal gyrus showed significantly decreased ReHo valuses compared to HRSLEs (P＜0.01). NPSLE and HRSLE subjects displayed significantly decreased fALFF values in areas of inferior parietal lobules, right dorsolateral superior frontal gyrus, and right middle frontal gyrus, compared to HCs (P＜0.01), among which right inferior lobules showed significantly decreased fALFF valuses compared to HRSLEs (P＜0.01). NPSLE and HRSLE subjects displayed significantly decreased DC values in areas of fusiform gyrus compared to HCs (P＜0.01). Conclusion:NPSLE group and HRSLE group both show areas with obvious fucntional alteraion in resting-state fMRI, among which, and inferior parietal lobules, fusiform gyrus, and left medial superior frontal gyrus may be useful in making an early dignosis of NPSLE.