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Brain perfusion and blood-brain barrier permeability in systemic lupus erythematosus patients : Associations with disease activity, cognitive dysfunction, fatigue and pain

Salomonsson, Tim LU orcid ; Zervides, Kristoffer A LU orcid ; Jönsen, Andreas LU ; Knutsson, Malte LU ; Wirestam, Ronnie LU orcid ; Lätt, Jimmy LU ; Bengtsson, Anders A LU ; Knutsson, Linda LU orcid and Sundgren, Pia C LU orcid (2025) In Neuroimage: Reports 5(1).
Abstract

High disease activity, cognitive dysfunction (CD), fatigue and pain negatively affect the quality of life in patients with systemic lupus erythematosus (SLE). However, the impact on brain perfusion and blood-brain barrier (BBB) permeability remains incompletely understood. Therefore, we utilized 3 T dynamic susceptibility contrast magnetic resonance imaging to investigate these factors in a cohort of 66 female SLE patients. Normalized leakage corrected cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and the BBB leakage parameter K
2, were compared within the cohort by splitting the group into patients with and without each symptom respectively. Fourteen regions of interest were chosen, and the... (More)

High disease activity, cognitive dysfunction (CD), fatigue and pain negatively affect the quality of life in patients with systemic lupus erythematosus (SLE). However, the impact on brain perfusion and blood-brain barrier (BBB) permeability remains incompletely understood. Therefore, we utilized 3 T dynamic susceptibility contrast magnetic resonance imaging to investigate these factors in a cohort of 66 female SLE patients. Normalized leakage corrected cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and the BBB leakage parameter K
2, were compared within the cohort by splitting the group into patients with and without each symptom respectively. Fourteen regions of interest were chosen, and the results were adjusted for age, disease duration, smoking and glucocorticoids. We found regional significant alterations in the different SLE subgroups compared to patients without each corresponding symptom, with patterns as follows: moderate to high disease activity (n = 17, decreased MTT, increased K
2), CD in ≥1 domain (n = 36, decreased MTT, increased K
2), CD in ≥2 domains (n = 20, increased CBF, CBV and K
2), fatigue (n = 44, increased CBV and MTT), pain (n = 9, increased CBF and CBV, decreased MTT). Additionally, inverse correlations were found between cognitive scores and K
2 in multiple areas, indicating increased BBB permeability with worse cognitive performance. To elucidate the underlying mechanisms, longitudinal studies should be conducted in a larger variation of patients, using different measurements of BBB disruption.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood-brain barrier permeability, Brain perfusion, Cognitive dysfunction, Dynamic susceptibility contrast MRI, Fatigue, Pain, Systemic lupus erythematosus
in
Neuroimage: Reports
volume
5
issue
1
article number
100232
publisher
Elsevier
external identifiers
  • pmid:40567893
  • scopus:85213556221
ISSN
2666-9560
DOI
10.1016/j.ynirp.2024.100232
language
English
LU publication?
yes
id
7aa9903b-13fd-417a-8aca-0ee59ed3d3ce
date added to LUP
2025-03-14 14:26:10
date last changed
2025-07-11 10:19:39
@article{7aa9903b-13fd-417a-8aca-0ee59ed3d3ce,
  abstract     = {{<p>High disease activity, cognitive dysfunction (CD), fatigue and pain negatively affect the quality of life in patients with systemic lupus erythematosus (SLE). However, the impact on brain perfusion and blood-brain barrier (BBB) permeability remains incompletely understood. Therefore, we utilized 3 T dynamic susceptibility contrast magnetic resonance imaging to investigate these factors in a cohort of 66 female SLE patients. Normalized leakage corrected cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and the BBB leakage parameter K<br>
 2, were compared within the cohort by splitting the group into patients with and without each symptom respectively. Fourteen regions of interest were chosen, and the results were adjusted for age, disease duration, smoking and glucocorticoids. We found regional significant alterations in the different SLE subgroups compared to patients without each corresponding symptom, with patterns as follows: moderate to high disease activity (n = 17, decreased MTT, increased K <br>
 2), CD in ≥1 domain (n = 36, decreased MTT, increased K <br>
 2), CD in ≥2 domains (n = 20, increased CBF, CBV and K <br>
 2), fatigue (n = 44, increased CBV and MTT), pain (n = 9, increased CBF and CBV, decreased MTT). Additionally, inverse correlations were found between cognitive scores and K<br>
 2 in multiple areas, indicating increased BBB permeability with worse cognitive performance. To elucidate the underlying mechanisms, longitudinal studies should be conducted in a larger variation of patients, using different measurements of BBB disruption.<br>
 </p>}},
  author       = {{Salomonsson, Tim and Zervides, Kristoffer A and Jönsen, Andreas and Knutsson, Malte and Wirestam, Ronnie and Lätt, Jimmy and Bengtsson, Anders A and Knutsson, Linda and Sundgren, Pia C}},
  issn         = {{2666-9560}},
  keywords     = {{Blood-brain barrier permeability; Brain perfusion; Cognitive dysfunction; Dynamic susceptibility contrast MRI; Fatigue; Pain; Systemic lupus erythematosus}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Elsevier}},
  series       = {{Neuroimage: Reports}},
  title        = {{Brain perfusion and blood-brain barrier permeability in systemic lupus erythematosus patients : Associations with disease activity, cognitive dysfunction, fatigue and pain}},
  url          = {{http://dx.doi.org/10.1016/j.ynirp.2024.100232}},
  doi          = {{10.1016/j.ynirp.2024.100232}},
  volume       = {{5}},
  year         = {{2025}},
}