Brain white matter structural networks in patients with non-neuropsychiatric systemic lupus erythematosus
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Previous neuroimaging studies have revealed cognitive dysfunction in patients with systemic lupus erythematosus (SLE) and suggested that it may be related to disrupted brain white matter (WM) connectivity. However, no study has examined the topological properties of brain WM structural networks in SLE patients, especially in patients with non-neuropsychiatric SLE (non-NPSLE). In this study, we acquired DTI datasets from 28 non-NPSLE patients and 24 healthy controls, constructed their brain WM structural networks by using a deterministic fiber tracking approach, estimated the topological parameters of their structural networks, and compared their group differences. We reached the following results: 1) At the global level, the non-NPSLE patients showed significantly increased characteristic path length, normalized clustering coefficient and small-worldness, but significantly decreased global efficiency and local efficiency compared to the controls; 2) At the nodal level, the non-NPSLE patients had significantly decreased nodal efficiency in regions related to movement control, executive control, and working memory (bilateral precentral gyri, bilateral middle frontal gyri, bilateral inferior parietal lobes, left median cingulate gyrus and paracingulate gyrus, and right middle temporal gyrus). In addition, to pinpointing the injured WM fiber tracts in the non-NPSLE patients, we reconstructed the major brain WM pathways connecting the abnormal regions at the nodal level with the corticospinal tract (CST), superior longitudinal fasciculus-parietal terminations (SLFP), and superior longitudinal fasciculus-temporal terminations (SLFT). By analyzing the diffusion parameters along these WM fiber pathways, we detected abnormal diffusion parameters in the bilateral CST and right SLFT in the non-NPSLE patients. These results seem to indicate that injured brain WM connectivity exists in SLE patients even in the absence of neuropsychiatric symptoms.
KeywordsDiffusion tensor imaging (DTI) Fractional anisotropy (FA) Fronto-parietal network Working memory network
diffusion tensor imaging;
systemic lupus erythematosus;
neuropsychiatric systemic lupus erythematosus;
non-neuropsychiatric systemic lupus erythematosus;
American College of Rheumatology;
Systemic Lupus Erythematosus Disease Activity Index;
Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index;
TRActs Constrained by UnderLying Anatomy algorithm;
central nervous system;
Tract-Based Spatial Statistics;
The authors express their appreciation to Drs. Rhoda E. and Edmund F. Perozzi for editing assistance and thank the two anonymous reviewers for their constructive comments and their suggestions.
Compliance with ethical standards
This work was partly supported by the Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, and was partly funded by the National Natural Science Foundation of China (Grant numbers: 81471654, 81428013, 81371535, 81271548, and 81271560).
Conflict of interests
The authors declare that they have no competing financial interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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