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.
autoimmune diseases; lupus erythematosus; magnetic resonance imaging; systemic; Anxiety; Anxiety Disorders; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Perfusion; Depression; Lupus Erythematosus, Systemic; Rheumatology; Immunology; General Medicine
Abstract :
[en] [en] OBJECTIVE: 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).
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
Disciplines :
Neurosciences & behavior
Author, co-author :
Antypa, Despina; Department of Psychiatry, University of Crete School of Medicine, Heraklion, Greece
Simos, Nikolaos-Ioannis ; Université de Liège - ULiège > GIGA > GIGA CRC In vivo Imaging - Sleep and chronobiology
Kavroulakis, Eleftherios; Department of Radiology, University of Crete, School of Medicine, Heraklion, Greece
Bertsias, George; Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece ; Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology-Hellas, Heraklion, Crete, Greece
Fanouriakis, Antonis ; Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece ; "Attikon" University Hospital, Athens, Greece
Sidiropoulos, Prodromos; Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece
Boumpas, Dimitrios; Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece ; "Attikon" University Hospital, Athens, Greece ; Laboratory of Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece ; Joint Academic Rheumatology Program, and 4th Department of Medicine, Medical School, National and Kapodestrian University of Athens, Athens, Greece
Papadaki, Efrosini ; Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece fpapada@otenet.gr ; Department of Radiology, University of Crete, School of Medicine, Heraklion, Greece
Language :
English
Title :
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.
HFRI - Hellenic Foundation for Research and Innovation [GR] ERC - European Research Council [BE]
Funding text :
Funding The study received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 Research and Innovation programme (grant agreement no 742390) to DB. Additional financial support was provided by the Hellenic Foundation for Research and Innovation (H.F.R.I.) under the “second Call for H.F.R.I. Research Projects to support Post-Doctoral Researchers” (Project Number: 1220) to EK. AF’s contribution to this work has been supported in part by a grant from the Hellenic Society of Rheumatology.
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