MRI Study Of Cortical Remodeling And Functional Connectivity In Female Patients With Non-Neuropsychiatric Systemic Lupus Erythematosus

purpose:Using voxel based morphometry(VBM)and functional connectivity(FC)measured by resting state functional magnetic resonance imaging(rs-fMRI),we aim to investigate the morphological changes and functional changes in the brain of female patients with non-neuropsychiatric systemic lupus erythematosus(non-NPSLE),and wish to find clinical biomarkers for brain morphological and functional changes in nonNPSLE patients.method:A total of 43 non-NPSLE female patients diagnosed in our hospital were enrolled,and 43 healthy controls(HC)matched by age,gender,and handedness were recruited.All subjects underwent rs-fMRI and T1 high-definition structure imaging scans.General information of all subjects and clinical data of non-NPSLE patients were recorded,including the symptoms and timing of the first onset,current symptoms and signs,as well as the latest test results of hematuria,C-reactive protein,erythrocyte sedimentation rate,complement(C3,C4),IgG,ANA spectrum and so on,and calculate the systemic lupus erythematosus disease activity index(SLEDAI)score.Then,the data processing assistant DPABI 4.0 of rs-fMRI was applied on the platform of MATLAB 2012 a.First,the structure image data was analyzed by VBM module,and the brain area with different gray matter volume between the two groups were obtained.Then the brain regions with different gray matter volume between the two groups were used as region of interest(ROI)to calculate their functional connections with other voxels in the whole brain.The difference between the two groups is compared by an independent two-sample T test.Finally,the gray matter volume(GMV)of the morphological abnormal brain region of the non-NPSLE group and the FC values of the functional difference coefficient of the significantly different brain regions were correlated with clinical parameters.Results:1.Compared with HC group,GMV in non-NPSLE group showed significant abnormalities,including increased gray matter volume in bilateral putamen,insular lobe,left posterior cerebellar lobe,right fusiform gyrus,and left paracentral lobule,and decreased gray matter volume in medial frontal gyrus,cuneus,calcarine and cingulate gyrus.2.Compared with HC group,the functional connections between the left posterior cerebellar lobe and the right inferior parietal lobule in non-NPSLE patients decreased;the functional connections between the right putamen-insula lobe and bilateral inferior frontal gyrus decreased;the functional connections between the left putamen and bilateral inferior frontal gyrus,left superior temporal gyrus and left limbic lobe decreased;and the functional connections between the left paracentral lobe and the superior frontal gyrus increased.3.GMV in right putamen-insula was positively correlated with course of disease,GMV in right putamen-insula was positively correlated with SLEDAI score,GMV in left putamen was positively correlated with SLEDAI score,GMV in left paracentral lobule was negatively correlated with SLEDAI score,GMV in left posterior cerebellar lobule was negatively correlated with complement C3 concentration,GMV in left paracentral lobule was positively correlated with complement C3 concentration,and GMV in left putamen was negatively correlated with complement C4 concentration.4.FC values of left posterior cerebellar lobe and right inferior parietal lobule,right putamen-insula lobe and right inferior frontal gyrus,left putamen and left superior temporal gyrus,left putamen and right inferior frontal gyrus,left putamen and left limbic lobe were positively correlated with complement C3 concentration;FC values of left putamen and right inferior frontal gyrus,left putamen and left limbic lobe were positively correlated with complement C4 concentration.Conclusions:1.Compared with the healthy control group,the non-NPSLE patients showed obvious brain morphological changes,and some of the morphological abnormal brain regions also had abnormal functional connections.It may be considered that brain morphological changes may be the basis of brain function changes.2.complement C3,C4 may participate in the occurrence of SLE brain damage,which helps us to further understand the pathogenesis of SLE brain damage,and early inhibition of complement C3,C4 may be beneficial to prevent the development of the disease.