BRAIN CONECTIONS

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 目的：本研究的三个具体目的是：1）确定近期诊断为SLE患者的认知功能连续测量值随时间的变化; 2）确定神经影像学对新诊断的SLE患者认知功能连续测量值下降的预测价值; 3）确定血清学因素对新诊断SLE患者认知功能连续测量下降的预测价值。 方法：30名患者将接受钆和脑FDG PET的基线MRI，标准神经心理学测试，由医生评估疾病活动性，并采集血液样本。 将有3 1/2至4年的季度访问，这取决于进入时间。 每次访视时，将重复以下内容：疾病活动性测量、血清、血浆和DNA储存、ANAM、抑郁量表、纤维肌痛压痛点、AIMS疼痛量表和ACR NPSLE病例定义。 预期结果：我们希望通过持续测量认知功能，发现新诊断SLE患者的临床相关数量出现中度至重度下降，而不受种族、教育、社会经济地位和合并症的影响;影像学异常在认知受损受试者中更常见;以及抗磷脂抗体水平的异常，细胞因子和可溶性粘附分子将与较差的认知功能相关。 临床相关性：系统性红斑狼疮（NPSLE）的神经精神症状是常见的，也是发病的重要原因。 在最近开发的NPSLE综合征的病例定义中，认知功能障碍似乎是最普遍的。 关于共病或种族/人种对疾病结局的影响或这种重要的NPSLE综合征的潜在发病机制知之甚少。 也许最重要的是，目前还没有合理的治疗方法来治疗SLE相关的认知功能障碍，如果不更好地了解神经病理机制，就不太可能开发出这种治疗方法。 使用结构和功能分析的新的脑成像技术有可能揭示NPSLE综合征的潜在机制，特别是如果针对特定的综合征。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVES: The three specific aims of this study are 1) to determine the change in continuous measures of cognitive function over time among patients with a recent diagnosis of SLE; 2) to determine the predictive value of neuroimaging for decline in continuous measures of cognitive function in newly diagnosed SLE patients; 3) to determine the predictive value of serologic factors for decline in continuous measures of cognitive function in newly diagnosed SLE patients. METHODS: Thirty patients will undergo a baseline MRI with gadolinium and brain FDG PET, standard neuropsychological testing, disease activity will be assessed by the physician, and a blood sample will be taken. There will be quarterly visits for 3 1/2 to 4 years, depending on entry time. At each visit, the following will be repeated: disease activity measures, serum, plasma, and DNA storage, ANAM, depression inventory, fibromyalgia tender points, AIMS pain scale and ACR NPSLE case definitions. EXPECTED OUTCOME: We hope to find a moderate to severe decline in a clinically relevant number of newly diagnosed SLE patients using continuous measures of cognitive function independent of race, education, socioeconomic status and co-morbid conditions; imaging abnormalities will be more common in cognitively impaired subjects; and abnormalities observed in levels of Antiphospholipid antibodies, cytokines and soluble adhesion molecules will be associated with poorer cognitive function. CLINICAL RELEVANCE: Neuropsychiatric manifestations of Systemic Lupus Erythematosus (NPSLE) are both common and an important source of morbidity. Of the case definitions for NPSLE syndromes that have recently been developed, cognitive dysfunction appears to be the most prevalent. Little is know about the influence of co-morbidities or ethnicity/race on disease outcomes or the underlying pathogenesis of this important NPSLE syndrome. Perhaps most importantly, no rational therapeutic approach for the treatment of SLE-related cognitive dysfunction currently exists and is unlikely to be developed without a better understanding of neuropathological mechanisms. New brain imaging techniques using both structural and functional analyses have the potential to uncover mechanisms underlying NPSLE syndrome, particularly if specific syndromes are targeted.