Abnormal cerebral hemodynamics and blood-brain barrier permeability detected with perfusion MRI in systemic lupus erythematosus patients

• DOI: 10.1016/j.nicl.2023.103390
• Publication Date: 2023-03-28T18:13:38Z
• Authors: T. Salomonsson; T. Rumetshofer; A. Jönsen; A.A. Bengtsson; K.A. Zervides; P. Nilsson; M. Knutsson; R. Wirestam; J. Lätt; L. Knutsson; P.C. Sundgren
• Keywords: Putamen

Dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) has previously shown alterations in cerebral perfusion patients with systemic lupus erythematosus (SLE). However, the results have been inconsistent, particular regarding neuropsychiatric (NP) SLE. Thus, we investigated perfusion-based measures different brain regions SLE and without NP involvement, additionally, white matter hyperintensities (WMHs), most common MRI pathology patients.We included 3 T images (conventional DSC) from 64 female 19 healthy controls (HC). Three NPSLE attribution models were used: Systemic Lupus International Collaborating Clinics (SLICC) A model (13 patients), SLICC B (19 American College of Rheumatology (ACR) case definitions for (38 patients). Normalized blood flow (CBF), volume (CBV) mean transit time (MTT) calculated 26 manually drawn interest compared between HC, non-NPSLE patients. Additionally, normalized CBF, CBV MTT, as well absolute values blood-brain barrier leakage parameter (K2) WMHs to normal appearing (NAWM) patients.After correction multiple comparisons, prevalent finding was a bilateral significant decrease MTT HC hypothalamus, putamen, right posterior thalamus anterior insula. Significant decreases also found CBF pons, putamen thalamus. increases corpus callosum callosum. Similar patterns both all attributional HC. no differences revealed regardless model. The showed increase metrics (CBF, CBV, K2) NAWM.Our study several independently involvement. Furthermore, increased K2 NAWM may indicate dysfunction We conclude that our show robust perfusion, independent models, provide insight into potential BBB altered vascular properties Despite being females, generalization conclusions should be avoided, future studies including sexes are needed.