The Research Of Brain Functional Magnetic Resonance Imaging On Migraine In Systemic Lupus Erythematosus

Objective: fMRI provid early imaging reference for diagnosis ofmigraine in SLE with negative convention imagine examination.Toapproach the neuropathological mechanism of SLE and further tovalidate migraine in SLE which is independent clinical manifestations ofcentral nervous system involvement by fMRI. To evaluate thecorrelation between SLE associated migraine degree, anxiety, depressiontendencies and cognitive dysfunction.Methods: Patients with SLE who had ever been hospitalized in WestChina hospital from Jan2011to Jan2012were investigated. Patientswith SLE complicated with migraine, patients with migraine, andhealthy controls were recruited into the study. Inclusion criteriaincluding:(1) age range18-55(2) right-handed (3) diagnosed using IHSmigraine criteria and visual analog scale>5(4) meeting the criteria ofSLE. The inclusion criteria of this study was strict. Patients with othersubtypes of NPSLE or showing abnormal changes on MRI wereexcluded. All the subjects completed measurements as following (1)Disease–related data was recorded.(2)MR imaging: the subjects wereasked to undergo brain MRI scanning. Two imaging techniques wereemployed in this study, structural magnetic resonance imaging andresting-state functional MRI (rsfMRI). Differences of发ALFF amongthree groups were calculated to estimate differences of brain activity.(3)Self-rating Anxiety Scale and Self-rating Depression Scale were used toassess psychological symptoms. Subjective cognitive function was alsoevaluated with several tests. The activity of disease and extent of organdamage were evaluated with SLEDAI and SLICC.(4) Laboratory examination: convention and immunological examination.Results1. Demographic data：There are408SLE Patients who had everbeen hospitalized in West China hospital from Jan2011to Jan2012.Neuropsychiatric systemic lupus erythematosus patients were142.42ofthese patients were diagnosed headache(29.57%), and15patients werediagnosed migraine.2. Resting state functional magnetic resonance imaging(rs-fMRI)showed：1)The differences of brain activity between patients with SLEand healthy controls spread in frontal lobes(both sides of middle frontalcortex).2)The differences of brain activity between SLE patients withmigraine who suffered Raynaud’s Phenomenon and healthy controlsspread in inferior parietal lobule,which conspious related to diseaseactivity3)the differences of brain activity between SLE and migraineshowed different brain activity in left cingulate gyrus and posteriorcentral gyrus, and interestingly, patients with SLE complicated withmigraine who had ever suffered Raynaud’s Phenomenon showedabnormal activity in cerebellar hemisphere.3.Half of patients with SLE complicated migraine whose SAS scoreswere more than50showed anxiety, and the percentage of patients withanxiety in migraine group was also50%. No psychological symptomswere observed in healthy controls.50%patients with SLE complicatedmigraine whose SDS scores were more than50showed depression, while10percent patients in migraine group showed this symptom.4. Cognitive function tests:①the mean time of part A of patientswith SLE was (55±4.422). It significantly increased, by comparing withpatients with migraine(35.1±2.401) and healthy control(38.8±2.287).②part B: the mean scores of patients with SLE was (83.6±5.857). It also significantly increased, by comparing with patients with migraine(56.3±5.452) and healthy control (53±2.068).③There find significantcorrelating between part A with part B.5.Half of patients with SLE complicated with Raynaud’sPhenomenon, which had not been observed in other two groups.Conclusions:1.fMRI is a sensitive imaging method to reflect the intracranialchanges of migraine in SLE with negative convention imagineexamination. It provid imaging reference for early diagnosis of migrainein SLE. Migraine is independent clinical manifestations of SLE centralnervous system involvement. the inferior parietal lobule could play a rolein the pathogenesis of migraine in SLE.2.Anxiety and Depression commonly existed in these patients withSLE complicated, correlating with SLEDAI and SLICC.3.There is a closely connective between migraine and cognitivedysfunction in SLE.4.There find no correlating between migraine degree andpsychological symptoms.