title: The Neurochemical and Microstructural Changes in the Brain of Systemic Lupus Erythematosus Patients: A Multimodal MRI Study.
abstract: The diagnosis and pathology of neuropsychiatric systemic lupus erythematosus (NPSLE) remains challenging. Herein, we used multimodal imaging to assess anatomical and functional changes in brains of SLE patients instead of a single MRI approach generally used in previous studies. Twenty-two NPSLE patients, 21 non-NPSLE patients and 20 healthy controls (HCs) underwent 3.0 T MRI with multivoxel magnetic resonance spectroscopy, T1-weighted volumetric images for voxel based morphometry (VBM) and diffusional kurtosis imaging (DKI) scans. While there were findings in other basal ganglia regions, the most consistent findings were observed in the posterior cingulate gyrus (PCG). The reduction of multiple metabolite concentration was observed in the PCG in the two patient groups, and the NPSLE patients were more prominent. The two patient groups displayed lower diffusional kurtosis (MK) values in the bilateral PCG compared with HCs (p < 0.01) as assessed by DKI. Grey matter reduction in the PCG was observed in the NPSLE group using VBM. Positive correlations among cognitive function scores and imaging metrics in bilateral PCG were detected. Multimodal imaging is useful for evaluating SLE subjects and potentially determining disease pathology. Impairments of cognitive function in SLE patients may be interpreted by metabolic and microstructural changes in the PCG.
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Zhiyan
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou 515041, China.
authors.forename: Yukai
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Zhongxian
authors.initials: Z
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of  Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China.|WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Endocrinology, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Dongxiao
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging, Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu 214062, China.
authors.forename: Gen
authors.initials: G
authors.lastname: Yan
authors.affiliation: Department of Medical Imaging, Guangzhou Huiai Hospital, Guangzhou 510515, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Yuanyu
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Xiangyong
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Medical Imaging, the 2nd Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.|Provincial Key Laboratory of Medical Molecular Imaging, Guangdong, Shantou 515041, China.
authors.forename: Renhua
authors.initials: R
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D016022:Case-Control Studies; D003342:Corpus Striatum / Q000378:metabolism / Q000473:pathology; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism / Q000473:pathology; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000378:metabolism* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D055442:Metabolome; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D013788:Thalamus / Q000378:metabolism / Q000473:pathology; D055815:Young Adult