Investigating The Role Of Eye's Sign And Functional Magnetic Resonance Imaging In Neuropsychiatric Lupus

Objective: To investigate the features of NPSLE patients by Eye's sign examination and fMRI scanning and the role of Eye's sign and fMRI in NPSLE patients.Methods: It was a case-control study in the first part.1098 patients were retrieved from the hospitalization system of The First Affiliated Hospital of Nanchang University from Sep 2017 to Sep 2018,30 NPSLE patients were identified.90 Non-NPSLE patients randomly selected among the resting 1068 SLE patients.120 enrolled patients were perfected blood examination and were double-bland evaluated SLEDAI / Headache VAS evaluation / Self-rating Anxiety Scale(SAS)/ Self-rating Depression Scale(SDS)and Self-rating Mental state Scale(MMSE).120 patients were then evaluated by Eye's sign examination and fMRI scanning.Calculating all data and analyze the significant items using T test,chi-square test,Wilcoxon rank sum test to identify the variables that were significantly different on univariate analysis and then to identify risk factors by using Logistic regression analysis.It was a confirmatory study in the second part.Setting a new diagnostic criterion according to risk factors and regarding the 1999 ACR classification as gold criteria.15 NPSLE patients were enrolled according to gold criteria and 30 Non-NPSLE patients were randomly selected.45 patients were evaluated by new criterion,and then divided into NPSLE and Non-NPSLE groups.Receiver operating characteristic curve were performed and area under the curve was calculated to evaluate new criterion.Result: 1.Sex ratio of 120 SLE patients was 1: 9,average age was 32.99 ? 1.033 years,and average SLE duration was 28.88 ? 1.799 month.They were averagely educated 9.54 ? 0.344 years and mainly in primary and high school.39 NP events were recorded in 30 NPSLE patients2.NPSLE had higher proportion of Raynaud's phenomenon and antiphospholipid antibodies(p<0.001).Scores of headache,MMSE,SAS,SDS,SLEDAI evaluations(p<0.001),ESR(p<0.05)in NPSLE group were higher than controls and national norms.4.Eye's sign examination showed NPSLE group were more suffered from blood stasis syndrome(p<0.001),the scores of ramified loop,microangioma,vascular tone,microangioma,wound point and total scores were higher in NPSLE group than controls(p<0.001).5.Scores of SLEDAI,ramified loop,microangioma,wound point and presence of antiphospholipid antibodies were risk factors of NPSLE.6.Compared with Non-NPSLE group,fMRI showed changed fALFF and ReHo in brain region relevant to cognition and emotion(p<0.01).7.Compared with the 1999 ACR classification,new criterion showed considerable diagnostic value and consistency,AUC of ROC is 0.815,sensitivity is 75.0%,specificity is 88.0%.Conclusion:1.NPSLE individuals were more suffered from headache,Raynaud's phenomenon and antiphospholipid antibodies,had higher scores of SLEDAI,MMSE,SAS,SDS evaluation than controls.2.NPSLE patients were more suffered from blood stasis syndrome,ramified loop,vascular tone,microangioma,wound point in Eye's sign examination.3.Differences of fALFF and ReHo in NPSLE mainly found in brain regions relating to Emotional and cognitive functions.4.Considerable diagnostic values and consistency were discovered using new criterion.