MRI and MRS Correlates of Cognitive Function in SLE

MRI 和 MRS 与 SLE 认知功能的相关性

• 批准号: 6827134
• 负责人: ELIZABETH KOZORA
• 金额: $ 29.02万
• 依托单位: NATIONAL JEWISH HEALTH
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-15 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6827134
• 关键词: brain imaging /visualization /scanning; brain morphology; clinical research; cognition disorders; gray matter; hippocampus; human subject; learning; magnetic resonance imaging; medical complication; memory; neural information processing; neurologic manifestations; neuropsychological tests; nuclear magnetic resonance spectroscopy; pathologic process; systemic lupus erythematosus; white matter

DESCRIPTION (provided by applicant): Systemic lupus erythematosus (SLE) patients without major overt neurological or psychiatric (NP) disorders have demonstrated cognitive dysfunction suggesting relatively subtle but clinically significant CNS involvement. Difficult diagnostic and treatment decisions are frequently necessary in these patients with cognitive abnormalities, and a better understanding of their underlying pathogenesis is critical to a rational approach to their management. We propose to identify potential mechanisms of cognitive dysfunction in SLE patients by examining quantitative brain structures (via MRI; magnetic resonance imaging), and neuronal metabolites (via MRS; proton magnetic resonance spectroscopy) in cognitively impaired SLE patients without NP disorders (CI-SLE). The specific aims of this proposal are first to compare CI-SLE to non-cognitively impaired SLE (NCI-SLE) and healthy control subjects on select quantitative MRI brain structures (whole brain and hippocampus) and proton MRS neurometabolites (NAA/Cr hippocampal structures and NAA/Cr; NAA/Cr and Cho/Cr in normal appearing white matter in frontal and parieto-occipital regions). Secondly, we aim to examine the relationship between cognitive deficits, brain structures and neurometabolites in the SLE patients. We will begin the analyses with a global relationship between a cognitive impairment index and whole brain measurement. We will then evaluate learning and memory measures in relation to the size of the hippocampus and NAA/Cr levels in that area. We will next examine attention/information processing in relation to total volume of white matter hyperintensities. Then we will examine NAA/Cr and Ch/Cr levels in frontal area of the brain in relation to attention/information processing and executive skills. Finally we will explore whether subjective cognitive complaints of SLE patients are associated with specific objective cognitive deficits, quantitative brain structures and select neurometabolites. We believe that understanding the biological abnormalities associated with cognitive dysfunction in SLE patients will guide further investigations directed at the underlying mechanisms of CNS changes in SLE. This will better prepare clinicians with clear diagnostic avenues and better treatment options in the future.

描述（由申请方提供）：无明显神经或精神（NP）疾病的系统性红斑狼疮（SLE）患者表现出认知功能障碍，提示相对轻微但具有临床意义的CNS受累。在这些认知异常的患者中，经常需要做出困难的诊断和治疗决定，更好地了解其潜在的发病机制对于合理的管理方法至关重要。我们建议通过检查无NP障碍的认知受损SLE患者（CI-SLE）的定量脑结构（通过MRI;磁共振成像）和神经元代谢物（通过MRS;质子磁共振波谱）来确定SLE患者认知功能障碍的潜在机制。本建议的具体目的是首先在选择的定量MRI脑结构（全脑和海马）和质子MRS神经代谢物（NAA/Cr海马结构和NAA/Cr;额叶和顶枕区正常出现的白色物质中的NAA/Cr和Cho/Cr）方面比较CI-SLE与非认知受损SLE（NCI-SLE）和健康对照受试者。其次，我们的目的是研究SLE患者的认知功能障碍，脑结构和神经代谢产物之间的关系。我们将开始分析与认知障碍指数和全脑测量之间的整体关系。然后，我们将评估学习和记忆的措施，在该地区的海马和NAA/Cr水平的大小。接下来，我们将研究注意力/信息处理与白色物质高强度总量的关系。然后，我们将检查大脑额叶区的NAA/Cr和Ch/Cr水平与注意/信息处理和执行技能的关系。最后，我们将探讨SLE患者的主观认知主诉是否与特定的客观认知缺陷、定量脑结构和选择的神经代谢物相关。我们相信，了解与SLE患者认知功能障碍相关的生物学异常将指导进一步研究SLE中枢神经系统变化的潜在机制。这将使临床医生在未来更好地准备明确的诊断途径和更好的治疗方案。