Abstract #2498

Altered patterns of cerebral perfusion in systemic lupus erythematosus patients with cognitive dysfunction, pain and fatigue.

Tim Salomonsson¹, Theodor Rumetshofer², Kristoffer Zervides³, Andreas Jönsen³, Petra Nilsson⁴, Malte Knutsson¹, Anders Bengtsson³, Ronnie Wirestam⁵, Jimmy Lätt⁶, Linda Knutsson^7,8, and Pia C. Sundgren^1,6,9

¹Department of Clinical Sciences/Radiology, Lund University, Lund, Sweden, ²Department of Clinical Sciences/Division of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden, ³Department of Clinical Sciences Lund/Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden, ⁴Department of Clinical Sciences Lund/Neurology, Lund University, Skåne University Hospital, Lund, Sweden, ⁵Department of Medical Radiation Physics, Lund University, Lund, Sweden, ⁶Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden, ⁷F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ⁸Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁹Lund University Bioimaging Center, Lund University, Lund, Sweden

Synopsis

Keywords: Neuroinflammation, DSC & DCE Perfusion, Systemic Lupus Erythematosus, Cognitive dysfunction, Fatigue, Pain, Fibromyalgia, Blood-brain barrier

Motivation: Cognitive dysfunction (CD), fatigue and pain are common and debilitating in systemic lupus erythematosus (SLE). Symptom-based neuroimaging could contribute to pathophysiological models and patient-centered care.

Goal(s): Investigating brain perfusion and blood-brain barrier permeability in SLE patients with CD, fatigue and pain.

Approach: 66 SLE patients underwent 3T dynamic susceptibility contrast (DSC) MRI. The leakage parameter K2 and normalized leakage corrected perfusion parameters were estimated in 14 brain regions, compared by symptomatology.

Results: Patients with CD or fibromyalgia displayed increased cerebral blood flow and/or cerebral blood volume in regions associated with pain processing. No differences were found for fatigue, K2 or mean transit time.

Impact: DSC-MRI detects cerebral hyperperfusion in systemic lupus erythematosus patients with cognitive dysfunction or the pain syndrome fibromyalgia, but not fatigue, suggesting different inflammatory or compensatory mechanisms. Investigating each of these debilitating symptoms separately might further characterize and guide patient-centered interventions.

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