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Altered medial temporal lobe subregion volumes in systemic lupus erythematosus patients with neuropsychiatric symptoms

Najeeb, Zahra Makdad LU ; Maly Sundgren, Pia LU orcid ; Jönsen, Andreas LU ; Zervides, Kristoffer A LU orcid ; Lätt, Jimmy LU ; Salomonsson, Tim LU orcid ; Nystedt, Jessika LU ; Nilsson, Petra LU ; Bengtsson, Anders LU and Kuchcinski, Grégory LU , et al. (2025) In BMC Rheumatology 9.
Abstract
Background: Systemic lupus erythematosus (SLE) often presents with neuropsychiatric (NP) involvement, including cognitive impairment and depression. Past magnetic resonance imaging (MRI) research in SLE patients showed smaller hippocampal volumes but did not investigate other medial temporal lobe (MTL) regions. Our study aims to compare MTL subregional volumes in SLE patients to healthy individuals (HI) and explore MTL subregional volumes in relation to neuropsychiatric SLE (NPSLE) manifestations.

Methods: A total of 70 SLE patients and 25 HI underwent clinical evaluation, cognitive testing, and 3 tesla MRI imaging. T1-weighted MRI images were analyzed using the Automatic Segmentation of Hippocampal Subfields-T1 software. Analyses... (More)
Background: Systemic lupus erythematosus (SLE) often presents with neuropsychiatric (NP) involvement, including cognitive impairment and depression. Past magnetic resonance imaging (MRI) research in SLE patients showed smaller hippocampal volumes but did not investigate other medial temporal lobe (MTL) regions. Our study aims to compare MTL subregional volumes in SLE patients to healthy individuals (HI) and explore MTL subregional volumes in relation to neuropsychiatric SLE (NPSLE) manifestations.

Methods: A total of 70 SLE patients and 25 HI underwent clinical evaluation, cognitive testing, and 3 tesla MRI imaging. T1-weighted MRI images were analyzed using the Automatic Segmentation of Hippocampal Subfields-T1 software. Analyses of Covariance were used to compare MTL subregion volumes between SLE and HI, and between NPSLE and non-NPSLE patients according to three models: the American College of Rheumatology (ACR) model defined by the ACR case definitions for NPSLE (n = 42), the more stringent Systemic Lupus International Collaborating Clinics (SLICC) B model (n = 21), and the most stringent SLICC A model (n = 15). Additionally, we explored the relation between MTL subregion volumes, cognitive functions, and depression scores in SLE patients using partial correlation analyses.

Results: Significantly smaller volumes of bilateral whole hippocampus, anterior hippocampus, posterior hippocampus, and Brodmann Area 35 were demonstrated in NPSLE compared to non-NPSLE patients according to the ACR model (p = 0.01, p = 0.03, p = 0.04, and p = 0.01 respectively). The differences did not reach significance according to the SLICC B and SLICC A models. No significant differences in MTL subregional volumes between SLE patients and HI were found. Partial correlation analyses showed a significant positive correlation between left Brodmann Area 35 volume and complex attention scores in SLE patients. No significant associations between MTL subregion volumes and depression scores were demonstrated.

Conclusions: NPSLE patients display significantly smaller volumes in various subregions of the MTL compared to non-NPSLE patients. These findings are suggestive of neuronal damage in MTL subregions in NPSLE patients on a group level.
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Contribution to journal
publication status
published
subject
in
BMC Rheumatology
volume
9
article number
10
publisher
BioMed Central (BMC)
external identifiers
  • pmid:39865321
ISSN
2520-1026
DOI
10.1186/s41927-024-00448-w
language
English
LU publication?
yes
id
b9a5889b-b6cb-498c-859f-33646150d964
date added to LUP
2025-02-04 11:49:10
date last changed
2025-02-05 03:09:58
@article{b9a5889b-b6cb-498c-859f-33646150d964,
  abstract     = {{Background: Systemic lupus erythematosus (SLE) often presents with neuropsychiatric (NP) involvement, including cognitive impairment and depression. Past magnetic resonance imaging (MRI) research in SLE patients showed smaller hippocampal volumes but did not investigate other medial temporal lobe (MTL) regions. Our study aims to compare MTL subregional volumes in SLE patients to healthy individuals (HI) and explore MTL subregional volumes in relation to neuropsychiatric SLE (NPSLE) manifestations.<br/><br/>Methods: A total of 70 SLE patients and 25 HI underwent clinical evaluation, cognitive testing, and 3 tesla MRI imaging. T1-weighted MRI images were analyzed using the Automatic Segmentation of Hippocampal Subfields-T1 software. Analyses of Covariance were used to compare MTL subregion volumes between SLE and HI, and between NPSLE and non-NPSLE patients according to three models: the American College of Rheumatology (ACR) model defined by the ACR case definitions for NPSLE (n = 42), the more stringent Systemic Lupus International Collaborating Clinics (SLICC) B model (n = 21), and the most stringent SLICC A model (n = 15). Additionally, we explored the relation between MTL subregion volumes, cognitive functions, and depression scores in SLE patients using partial correlation analyses.<br/><br/>Results: Significantly smaller volumes of bilateral whole hippocampus, anterior hippocampus, posterior hippocampus, and Brodmann Area 35 were demonstrated in NPSLE compared to non-NPSLE patients according to the ACR model (p = 0.01, p = 0.03, p = 0.04, and p = 0.01 respectively). The differences did not reach significance according to the SLICC B and SLICC A models. No significant differences in MTL subregional volumes between SLE patients and HI were found. Partial correlation analyses showed a significant positive correlation between left Brodmann Area 35 volume and complex attention scores in SLE patients. No significant associations between MTL subregion volumes and depression scores were demonstrated.<br/><br/>Conclusions: NPSLE patients display significantly smaller volumes in various subregions of the MTL compared to non-NPSLE patients. These findings are suggestive of neuronal damage in MTL subregions in NPSLE patients on a group level.<br/>}},
  author       = {{Najeeb, Zahra Makdad and Maly Sundgren, Pia and Jönsen, Andreas and Zervides, Kristoffer A and Lätt, Jimmy and Salomonsson, Tim and Nystedt, Jessika and Nilsson, Petra and Bengtsson, Anders and Kuchcinski, Grégory and Wisse, Laura}},
  issn         = {{2520-1026}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Rheumatology}},
  title        = {{Altered medial temporal lobe subregion volumes in systemic lupus erythematosus patients with neuropsychiatric symptoms}},
  url          = {{http://dx.doi.org/10.1186/s41927-024-00448-w}},
  doi          = {{10.1186/s41927-024-00448-w}},
  volume       = {{9}},
  year         = {{2025}},
}