{"title":"系统性红斑狼疮患者血脑屏障功能与疾病活动性和认知功能的关系。","authors":"Xueying Zhao, Zexi Yi, Yimin Cao, Cong Zhang, Zhijuan Li, Duo Gao, Sicong Wang, Zuojun Geng, Haiqing Yang, Shifeng Xiang, Yali Wang, Yue Zhang, Lixia Zhou","doi":"10.1002/jmri.70143","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Disruption of the blood-brain barrier (BBB) is an important mechanism in the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE), potentially influencing disease progression and cognitive function.</p><p><strong>Purpose: </strong>To investigate voxel-wise BBB permeability differences among NPSLE, non-NPSLE, and healthy controls (HC) using dynamic contrast-enhanced MRI (DCE-MRI), and explore associations with disease activity and cognitive function.</p><p><strong>Study type: </strong>Multicenter, cross-sectional study.</p><p><strong>Subjects: </strong>22 NPSLE patients, 24 non-NPSLE patients, and 27 age- and sex-matched HC.</p><p><strong>Field strength/sequence: </strong>3.0 Tesla, GE: 3D T1-FSPGR, DCE-LAVA-Flex sequences; Philips: 3D T1-FFE, eTHRIVE sequences.</p><p><strong>Assessment: </strong>Post-processing of DCE-MRI images was conducted to calculate the volume transfer constant (K<sup>trans</sup>) and plasma volume fraction (V<sub>p</sub>) maps, which were transformed to Montreal Neurological Institute space. Brain regions were defined using the Anatomical Automatic Labeling (AAL) atlas. Group differences among NPSLE, non-NPSLE, and HC were assessed. Mean K<sup>trans</sup>/V<sub>p</sub> values from suprathreshold clusters were evaluated for associations with the Disease Activity Index (SLEDAI) and Montreal Cognitive Assessment (MoCA) scores. Mean K<sup>trans</sup>/V<sub>p</sub> from corresponding AAL regions was extracted for further validation of the observed correlations.</p><p><strong>Statistical tests: </strong>Voxel-wise ANOVA with Tukey's HSD test; Spearman correlation and linear regression. Threshold: Voxel-wise p < 0.001, cluster size > 20; group comparisons p < 0.05.</p><p><strong>Results: </strong>A significantly elevated K<sup>trans</sup> was observed in the right caudate of NPSLE patients compared to non-NPSLE patients, and hippocampal K<sup>trans</sup> was significantly higher in NPSLE than both non-NPSLE and HC. Both NPSLE and non-NPSLE patients exhibited widespread significant increases in V<sub>p</sub> compared to HC. In the entire SLE cohort, right caudate K<sup>trans</sup> was positively associated with SLEDAI (ρ = 0.43, R<sup>2</sup> = 0.18) and negatively associated with MoCA scores (ρ = -0.35, R<sup>2</sup> = 0.12) after adjusting for confounding factors.</p><p><strong>Data conclusion: </strong>This study provided voxel-level evidence linking regional BBB leakage to both disease activity and cognitive impairment in SLE.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Blood-Brain Barrier Function With Disease Activity and Cognitive Function in Systemic Lupus Erythematosus Patients.\",\"authors\":\"Xueying Zhao, Zexi Yi, Yimin Cao, Cong Zhang, Zhijuan Li, Duo Gao, Sicong Wang, Zuojun Geng, Haiqing Yang, Shifeng Xiang, Yali Wang, Yue Zhang, Lixia Zhou\",\"doi\":\"10.1002/jmri.70143\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Disruption of the blood-brain barrier (BBB) is an important mechanism in the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE), potentially influencing disease progression and cognitive function.</p><p><strong>Purpose: </strong>To investigate voxel-wise BBB permeability differences among NPSLE, non-NPSLE, and healthy controls (HC) using dynamic contrast-enhanced MRI (DCE-MRI), and explore associations with disease activity and cognitive function.</p><p><strong>Study type: </strong>Multicenter, cross-sectional study.</p><p><strong>Subjects: </strong>22 NPSLE patients, 24 non-NPSLE patients, and 27 age- and sex-matched HC.</p><p><strong>Field strength/sequence: </strong>3.0 Tesla, GE: 3D T1-FSPGR, DCE-LAVA-Flex sequences; Philips: 3D T1-FFE, eTHRIVE sequences.</p><p><strong>Assessment: </strong>Post-processing of DCE-MRI images was conducted to calculate the volume transfer constant (K<sup>trans</sup>) and plasma volume fraction (V<sub>p</sub>) maps, which were transformed to Montreal Neurological Institute space. Brain regions were defined using the Anatomical Automatic Labeling (AAL) atlas. Group differences among NPSLE, non-NPSLE, and HC were assessed. Mean K<sup>trans</sup>/V<sub>p</sub> values from suprathreshold clusters were evaluated for associations with the Disease Activity Index (SLEDAI) and Montreal Cognitive Assessment (MoCA) scores. Mean K<sup>trans</sup>/V<sub>p</sub> from corresponding AAL regions was extracted for further validation of the observed correlations.</p><p><strong>Statistical tests: </strong>Voxel-wise ANOVA with Tukey's HSD test; Spearman correlation and linear regression. Threshold: Voxel-wise p < 0.001, cluster size > 20; group comparisons p < 0.05.</p><p><strong>Results: </strong>A significantly elevated K<sup>trans</sup> was observed in the right caudate of NPSLE patients compared to non-NPSLE patients, and hippocampal K<sup>trans</sup> was significantly higher in NPSLE than both non-NPSLE and HC. Both NPSLE and non-NPSLE patients exhibited widespread significant increases in V<sub>p</sub> compared to HC. In the entire SLE cohort, right caudate K<sup>trans</sup> was positively associated with SLEDAI (ρ = 0.43, R<sup>2</sup> = 0.18) and negatively associated with MoCA scores (ρ = -0.35, R<sup>2</sup> = 0.12) after adjusting for confounding factors.</p><p><strong>Data conclusion: </strong>This study provided voxel-level evidence linking regional BBB leakage to both disease activity and cognitive impairment in SLE.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.70143\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.70143","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Association of Blood-Brain Barrier Function With Disease Activity and Cognitive Function in Systemic Lupus Erythematosus Patients.
Background: Disruption of the blood-brain barrier (BBB) is an important mechanism in the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE), potentially influencing disease progression and cognitive function.
Purpose: To investigate voxel-wise BBB permeability differences among NPSLE, non-NPSLE, and healthy controls (HC) using dynamic contrast-enhanced MRI (DCE-MRI), and explore associations with disease activity and cognitive function.
Study type: Multicenter, cross-sectional study.
Subjects: 22 NPSLE patients, 24 non-NPSLE patients, and 27 age- and sex-matched HC.
Field strength/sequence: 3.0 Tesla, GE: 3D T1-FSPGR, DCE-LAVA-Flex sequences; Philips: 3D T1-FFE, eTHRIVE sequences.
Assessment: Post-processing of DCE-MRI images was conducted to calculate the volume transfer constant (Ktrans) and plasma volume fraction (Vp) maps, which were transformed to Montreal Neurological Institute space. Brain regions were defined using the Anatomical Automatic Labeling (AAL) atlas. Group differences among NPSLE, non-NPSLE, and HC were assessed. Mean Ktrans/Vp values from suprathreshold clusters were evaluated for associations with the Disease Activity Index (SLEDAI) and Montreal Cognitive Assessment (MoCA) scores. Mean Ktrans/Vp from corresponding AAL regions was extracted for further validation of the observed correlations.
Statistical tests: Voxel-wise ANOVA with Tukey's HSD test; Spearman correlation and linear regression. Threshold: Voxel-wise p < 0.001, cluster size > 20; group comparisons p < 0.05.
Results: A significantly elevated Ktrans was observed in the right caudate of NPSLE patients compared to non-NPSLE patients, and hippocampal Ktrans was significantly higher in NPSLE than both non-NPSLE and HC. Both NPSLE and non-NPSLE patients exhibited widespread significant increases in Vp compared to HC. In the entire SLE cohort, right caudate Ktrans was positively associated with SLEDAI (ρ = 0.43, R2 = 0.18) and negatively associated with MoCA scores (ρ = -0.35, R2 = 0.12) after adjusting for confounding factors.
Data conclusion: This study provided voxel-level evidence linking regional BBB leakage to both disease activity and cognitive impairment in SLE.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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