Aberrant functional connectivity between anterior cingulate cortex and left insula in association with therapeutic response to biologics in inflammatory arthritis
Aberrant functional connectivity between anterior cingulate cortex and left insula in association with therapeutic response to biologics in inflammatory arthritis
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DOI：
10.1016/j.semarthrit.2022.151994
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发表时间：
2022-03-21
影响因子：
5
通讯作者：
Atsumi, Tatsuya
中科院分区：
文献类型：
--
作者：
Abe, Nobuya;Fujieda, Yuichiro;Atsumi, Tatsuya
背景：脑活动与个体的疼痛易感性和炎症状态有关，可能有助于炎症性关节炎(IA)包括类风湿性关节炎(RA)和脊柱性关节炎(SpA)的疾病活动评估。然而，脑功能的改变与IA的疾病活动性和治疗效果之间的关系尚不清楚。目的：利用功能磁共振成像(MRI)研究RA和SpA患者脑功能连接性(FC)的改变及其与抗风湿治疗反应的关系。患者和方法：结构和静息状态的功能MRI数据来自IA患者、骨关节炎(OA)患者和健康对照组(HCS)。采用两个数据集(51个IA、56个OA和17个HC)来推导和验证(31 IA)观察结果。派生数据集中的33例IA患者和验证数据集中的所有患者都需要进行生物治疗，并在治疗前后进行临床评估。结果：IA患者左侧岛叶皮质(IC)和前扣带回皮质(ACC)之间的FC值显著低于OA患者和HCS患者。结论：疾病特异性静息状态FC提供了一种评估PGA治疗效果的方法，对RA和SpA的治疗反应均具有可预测性。(C)2022 Elsevier Inc.保留所有权利。
Background: Brain activity is reported to be associated with individual pain susceptibility and inflammatory status, possibly contributing to disease activity assessment in inflammatory arthritis (IA) including rheumatoid arthritis (RA) and spondyloarthritis (SpA). However, what alteration of brain function associated with disease activity and therapeutic effectiveness in IA remains unclear. We aimed to identify the alterations of brain functional connectivity (FC) shared in both RA and SpA, and evaluate its relationship to anti-rheumatic treatment response using functional magnetic resonance imaging (MRI).Patients and methods: Structural and resting-state functional MRI data were acquired from patients with IA, patients with osteoarthritis (OA) and heathy controls (HCs). Two datasets were adopted to derive (51 IA, 56 OA, and 17 HCs) and validate (31 IA) the observations. 33 IA patients in the derivation dataset and all the patients in validation dataset required biological treatment and were clinically evaluated before and after therapy. Via whole-brain pair-wise FC analyses, we analyzed IA-specific FC measures relevant to therapeutic response to biologics.Results: The value of FC between left insular cortex (IC) and anterior cingulate cortex (ACC) was significantly low in IA patients compared with OA patients and HCs. We demonstrated that the FC between left anterior long insular gyrus as a subdivision of IC and ACC was significantly associated with therapeutic response to biologics regarding the improvement of patients' global assessment (PGA) in both derivation and validation datasets.Conclusion: Disease-specific resting-state FC provides a means to assess the therapeutic improvement of PGA and would be a clinical decision-making tool with predictability for treatment response in both RA and SpA. (c) 2022 Elsevier Inc. All rights reserved.