TY - JOUR
TI - Anxiety and depression severity in neuropsychiatric SLE are associated with perfusion and functional connectivity changes of the frontolimbic neural circuit: A resting-state f(unctional) MRI study
AU - Antypa, D.
AU - Simos, N.J.
AU - Kavroulakis, E.
AU - Bertsias, G.
AU - Fanouriakis, A.
AU - Sidiropoulos, P.
AU - Boumpas, D.
AU - Papadaki, E.
JO - Lupus Science and Medicine
PY - 2021
VL - 8
TODO - 1
SP - null
PB - BMJ Publishing Group
SN - null
TODO - 10.1136/lupus-2020-000473
TODO - adult;  amygdala;  anterior cingulate;  anterior commissure;  anxiety disorder;  Article;  brain mapping;  brain region;  cerebrovascular disease;  clinical article;  cognitive defect;  confusion;  controlled study;  cranial neuropathy;  depression;  disease duration;  female;  follow up;  frontal gyrus;  functional connectivity;  functional magnetic resonance imaging;  functional neuroimaging;  hemodynamics;  Hospital Anxiety and Depression Scale;  human;  lateral orbitofrontal cortex;  limbic cortex;  male;  medial orbitofrontal cortex;  middle aged;  middle frontal gyrus;  mood disorder;  neuropsychiatric systemic lupus erythematosus;  polyneuropathy;  posterior commissure;  precuneus;  prefrontal cortex;  priority journal;  psychosis;  seizure;  SLEDAI;  smoking;  spinal cord disease;  symptomatology;  systemic lupus erythematosus;  white matter
TODO - To examine the hypothesis that perfusion and functional connectivity disturbances in brain areas implicated in emotional processing are linked to emotion-related symptoms in neuropsychiatric SLE (NPSLE). Resting-state fMRI (rs-fMRI) was performed and anxiety and/or depression symptoms were assessed in 32 patients with NPSLE and 18 healthy controls (HC). Whole-brain time-shift analysis (TSA) maps, voxel-wise global connectivity (assessed through intrinsic connectivity contrast (ICC)) and within-network connectivity were estimated and submitted to one-sample t-tests. Subgroup differences (high vs low anxiety and high vs low depression symptoms) were assessed using independent-samples t-tests. In the total group, associations between anxiety (controlling for depression) or depression symptoms (controlling for anxiety) and regional TSA or ICC metrics were also assessed. Elevated anxiety symptoms in patients with NPSLE were distinctly associated with relatively faster haemodynamic response (haemodynamic lead) in the right amygdala, relatively lower intrinsic connectivity of orbital dlPFC, and relatively lower bidirectional connectivity between dlPFC and vmPFC combined with relatively higher bidirectional connectivity between ACC and amygdala. Elevated depression symptoms in patients with NPSLE were distinctly associated with haemodynamic lead in vmPFC regions in both hemispheres (lateral and medial orbitofrontal cortex) combined with relatively lower intrinsic connectivity in the right medial orbitofrontal cortex. These measures failed to account for self-rated, milder depression symptoms in the HC group. By using rs-fMRI, altered perfusion dynamics and functional connectivity was found in limbic and prefrontal brain regions in patients with NPSLE with severe anxiety and depression symptoms. Although these changes could not be directly attributed to NPSLE pathology, results offer new insights on the pathophysiological substrate of psychoemotional symptomatology in patients with lupus, which may assist its clinical diagnosis and treatment. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
ER -