Abstract
Purpose
Τhe study examined changes in hemodynamics and functional connectivity in patients with systemic lupus erythematosus (SLE) with or without neuropsychiatric manifestations.
Methods
Participants were 44 patients with neuropsychiatric SLE (NPSLE), 20 SLE patients without such manifestations (non-NPSLE), and 35 healthy controls. Resting-state functional MRI (rs-fMRI) was used to obtain whole-brain maps of (a) perfusion dynamics derived through time shift analysis (TSA), (b) regional functional connectivity (intrinsic connectivity contrast (ICC) coefficients), and (c) hemodynamic-connectivity coupling. Group differences were assessed through independent samples t-tests, and correlations of rs-fMRI indices with clinical variables and neuropsychological test scores were, also, computed.
Results
Compared to HC, NPSLE patients demonstrated intrinsic hypoconnectivity of anterior Default Mode Network (DMN) and hyperconnectivity of posterior DMN components. These changes were paralleled by elevated hemodynamic lag. In NPSLE, cognitive performance was positively related to higher intrinsic connectivity in these regions, and to higher connectivity-hemodynamic coupling in posterior DMN components. Uncoupling between hemodynamics and connectivity in the posterior DMN was associated with worse task performance. Non-NPSLE patients displayed hyperconnectivity in posterior DMN and sensorimotor regions paralleled by relatively increased hemodynamic lag.
Conclusion
Adaptation of regional brain function to hemodynamic changes in NPSLE may involve locally decreased or locally increased intrinsic connectivity (which can be beneficial for cognitive function). This process may also involve elevated coupling of hemodynamics with functional connectivity (beneficial for cognitive performance) or uncoupling, which may be detrimental for the cognitive skills of NPSLE patients.
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Data availability
The computed metrics derived from resting state fMRI recordings will be available upon request.
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Funding
Financial support for this work was provided by the Hellenic Foundation for Research and Innovation (H.F.R.I.) under the “2nd Call for H.F.R.I. Research Projects to support Post-Doctoral Researchers” (Project Number: 1220).
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Conceptualization: Efrosini Papadaki; Nicholas Simos
Methodology: Efrosini Papadaki; Nicholas Simos; Eleftherios Kavroulakis
Formal analysis and investigation: Nicholas Simos; Eleftherios Kavroulakis
Writing — original draft preparation: Efrosini Papadaki; Despina Antypa; Nicholas Simos
Writing — review and editing: Efrosini Papadaki; George Bertsias; Thomas Maris; Dimitrios Boumpas
Funding acquisition: Eleftherios Kavroulakis
Resources: George Bertsias; Antonis Fanouriakis; Prodromos Sidiropoulos
Supervision: Efrosini Papadaki; Dimitrios Boumpas
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The hospital review board approved this study and the procedure was thoroughly explained to all patients and volunteers who signed informed consent.
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Papadaki, E., Simos, N.J., Kavroulakis, E. et al. Converging evidence of impaired brain function in systemic lupus erythematosus: changes in perfusion dynamics and intrinsic functional connectivity. Neuroradiology 64, 1593–1604 (2022). https://doi.org/10.1007/s00234-022-02924-x
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DOI: https://doi.org/10.1007/s00234-022-02924-x