# Assessing grey matter structural alterations in systemic lupus erythematosus using synthetic MRI

## TL;DR

This study uses synthetic MRI to find brain grey matter changes in lupus patients and links them to cognitive and mental health issues.

## Contribution

The study identifies grey matter structural alterations in SLE patients and their correlation with neuropsychological outcomes using synthetic MRI.

## Key findings

- Patients with SLE showed reduced grey matter volume compared to healthy controls.
- NPSLE patients had more extensive T1 and T2 relaxation time increases in grey matter than non-NPSLE patients.
- Lower MMSE/MoCA scores correlated with increased T1/T2 in specific brain regions.

## Abstract

To assess brain grey matter alterations in patients with SLE and their correlation with neuropsychological testing using synthetic MRI (SyMRI).

This prospective study enrolled patients with SLE and age, gender and education-matched healthy controls (HC). Study assessments included brain MRI using SyMRI and neuropsychological tests: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit Span Test, Self-Rating Anxiety Scale and Self-Rating Depression Scale (SDS). SyMRI post-processing and Automated Anatomical Labeling were used for grey matter mapping. Correlation analysis was performed to assess the relationship between brain grey matter structural alterations and neuropsychological testing.

77 patients with SLE (57 non-neuropsychiatric SLE (non-NPSLE), 20 NPSLE) and 29 HC participants were enrolled. Patients with SLE showed reduced grey matter volume compared with HC (p<0.05). The NPSLE group exhibited more extensive increases in longitudinal (T1) and transverse (T2) relaxation times in grey matter than the non-NPSLE group (p<0.001). Proton density values were lower in patients with SLE (p<0.001). Lower brain parenchymal volume correlated with higher SLE Disease Activity Index (p<0.05). Lower MMSE/MoCA scores correlated with increased T1/T2 in the left medial cingulate and paracingulate gyri (p<0.05). Higher SDS scores correlated with increased T1/T2 in the left calcarine fissure and surrounding cortex (p<0.05). These changes were also linked to disease markers (C3, C4, immunoglobulin M, erythrocyte sedimentation rate) (p<0.05).

Grey matter alterations in patients with SLE correlate with cognitive impairment, depression and disease activity.