title: Structural Brain Network Reorganization in Patients with Neuropsychiatric Systemic Lupus Erythematosus.
abstract: Patients with neuropsychiatric systemic lupus erythematosus have worse outcomes compared with those with systemic lupus erythematosus. A better understanding of the mechanisms of neuropsychiatric systemic lupus erythematosus could potentially improve diagnosis and management. The goal of this study was to investigate the differences in the structural brain network of patients with neuropsychiatric systemic lupus erythematosus compared with patients with systemic lupus erythematosus by using brain connectivity analysis.
  
  
  
  We recruited 20 subjects for each patient cohort and age-matched healthy controls. The topology and efficiency of the network and the characteristics of various brain hubs were investigated by using brain connectivity analysis of diffusion MR imaging data.
  
  
  
  There were more extensive reorganizations in the structural brain network of patients with neuropsychiatric systemic lupus erythematosus than in patients with systemic lupus erythematosus. For example, the network of the former had significantly decreased clustering coefficient and local efficiency. They also had significantly lower nodal efficiency in the superior temporal gyrus (P = .046) and middle temporal gyrus (P = .041).
  
  
  
  Our results hint at a plausible relationship between the neuropsychiatric symptoms and reorganization of the structural brain network of patients with systemic lupus erythematosus. Brain connectivity analysis may be a potential tool to subtype these patients.
authors.affiliation: From the Department of Diagnostic Radiology (X.X., E.S.H., H.K.F.M.).
authors.forename: X
authors.identifier: 0000-0002-0342-383X
authors.initials: X
authors.lastname: Xu
authors.affiliation: From the Department of Diagnostic Radiology (X.X., E.S.H., H.K.F.M.) edward.s.hui@gmail.com makkf@hku.hk.
authors.forename: E S
authors.identifier: 0000-0002-1761-0169
authors.initials: ES
authors.lastname: Hui
authors.affiliation: Department of Biomedical Sciences (M.Y.M.), City University of Hong Kong, Kowloon Tong, Hong Kong Special Administrative Region.
authors.forename: M Y
authors.identifier: 0000-0003-4898-2114
authors.initials: MY
authors.lastname: Mok
authors.affiliation: Radiology Department (J.J.), The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi China.
authors.forename: J
authors.identifier: 0000-0001-5209-9004
authors.initials: J
authors.lastname: Jian
authors.affiliation: Division of Rheumatology and Clinical Immunology (C.S.L.), Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
authors.forename: C S
authors.identifier: 0000-0001-6698-8355
authors.initials: CS
authors.lastname: Lau
authors.affiliation: From the Department of Diagnostic Radiology (X.X., E.S.H., H.K.F.M.) edward.s.hui@gmail.com makkf@hku.hk.
authors.forename: H K F
authors.identifier: 0000-0002-2007-0650
authors.initials: HK
authors.lastname: Mak
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged