Alterations in cerebral perfusion and corresponding brain functional networks in systemic lupus erythematosus with cognitive impairment

Abstract Cognitive impairment (CI) frequently occurs in patients with systemic lupus erythematosus (SLE) and may result from neuroinflammation processes and neurovascular changes in the brain. The cerebral hemodynamics underlying SLE with CI (SLE-CI) remain unclear. 97 patients with SLE and 51 heathy controls (HCs) matched for age and gender underwent magnetic resonance imaging (MRI). The CI status of patients was measured using the Montreal Cognitive Assessment (MoCA). 3D T1-weighted arterial spin labeling (ASL) and resting-state functional (rs-fMRI) sequences were obtained. Seed-based FC was calculated using the CBF results. Compared with patients with SLE-NC, patients with SLE-CI had higher CBF in the left hippocampus, thalamus, and cerebellum crus II and lower CBF in the left frontal lobe. Left hippocampus gray matter (GM) atrophy was detected in patients with SLE-CI but not in patients with SLE-NC. Secondary analyses revealed that compared with patients with SLE-NC, patients with SLE-CI had increased FC of the left insula gyrus when the left cerebellum crus II was set as the seed region and decreased FC in the homolateral parahippocampus when the left hippocampus was set as the seed region. These changes in brain structure, function, and network may be biomarkers of cognitive impairment in patients with SLE-CI.