Abstract #1792

Blood-Brain Barrier Imaging as a Biomarker for Cognitive Decline in Systemic Lupus Erythematosus

Lyna Kamintsky¹, Steven D Beyea^2,3, John D Fisk^4,5, Javeria A Hashmi⁶, Antonina Omisade⁷, Tim Bardouille⁸, Chris Bowen^2,3, Maher Quraan^2,3, Kara A Matheson⁹, Alon Friedman^1,10, and John G Hanly^11,12

¹Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada, ²Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada, ³Biomedical Translational Imaging Centre (BIOTIC), QEII Health Sciences Centre, Halifax, NS, Canada, ⁴Departments of Psychiatry, Psychology & Neuroscience and Medicine, Dalhousie University, Halifax, NS, Canada, ⁵Nova Scotia Health Authority, Halifax, NS, Canada, ⁶Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada, ⁷Acquired Brain Injury (Epilepsy Program), Nova Scotia Health Authority, Halifax, NS, Canada, ⁸Department of Physics, Dalhousie University, Halifax, NS, Canada, ⁹Research Methods Unit, Nova Scotia Health Authority, Halifax, NS, Canada, ¹⁰Department of Physiology and Cell Biology, Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel, ¹¹QEII Health Sciences Center, Halifax, NS, Canada, ¹²Department of Medicine and Division of Rheumatology, Dalhousie University, Halifax, NS, Canada

This study addresses the need for mechanism-based understanding of cognitive impairment in systemic lupus erythematosus (SLE). Using dynamic contrast-enhanced MRI we identified extensive blood-brain barrier (BBB) leakage in 16 of 46 SLE patients. Extensive BBB leakage was associated with worse overall cognitive performance, affecting primarily information processing speed and executive abilities. Our study provides the first compelling evidence for BBB damage in SLE, and links BBB leakage to cognitive dysfunction. These findings highlight the diagnostic potential of BBB imaging and call for research into BBB-targeting therapies.

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