Neuropsychiatric Symptoms and MRI Markers in SLE Patients with APLA

患有 APLA 的 SLE 患者的神经精神症状和 MRI 标志物

基本信息

批准号：
8062285
负责人：
LAURA J JULIAN
金额：
$ 4.72万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8062285
关键词：
Anterior Antiphospholipid Antibodies Autoimmune Process Behavioral Brain Brain region CNS processing Cerebrovascular Disorders Characteristics Chronic Clinical Clinical Research Data Development Diffusion Magnetic Resonance Imaging Etiology Evaluation Foundations Functional disorder Future Gold Guide prevention Imaging Techniques Imaging technology Impaired cognition Intervention Investigation Kidney Lesion Link Literature Lung Magnetic Resonance Magnetic Resonance Imaging Mental Depression Microscopic Modeling Morbidity - disease rate Multiple Sclerosis Neuraxis Neurologic Neuropsychiatric Systemic Lupus Erythematosus Outcome Patients Pattern Quality of life Relative (related person)Reporting Risk Risk Factors Sampling Severities Symptoms Systemic Lupus Erythematosus Techniques Testing Weight Work base body system cerebrovascular clinical care cognitive function depressive symptoms design executive function gray matter improved innovation mortality multidisciplinary neuroimaging neuropsychiatry serological marker white matter

项目摘要

This is an application for a Development and Feasibility (D & F) project as part of the Multidisciplinary Clinical Research Center proposal. Systemic lupus erythematosus (SLE) is a disabling autoimmune condition with multi-organ system involvement. Recently central nervous system (CMS) involvement has emerged as a major cause of morbidity in SLE. Patients with SLE have an increased risk for cerebrovascular disease (CVD), and the presence of antiphospholipid antibodies (APLAs) is a recognized risk factor. APLAs are also associated with cognitive dysfunction and markers on magnetic resonance imaging (MRI) studies, even in the absence of other overt neurological signs. Cognitive dysfunction and depression are among the most common manifestations within the neuropsychiatric SLE spectrum. In SLE, etiologies of these symptoms remain unclear, although preliminary studies in multiple sclerosis, and extant literature in CVD suggest that these symptoms are associated with structural changes in frontal brain regions visible by MRI studies. The proposed study is a cross-sectional investigation of MRI markers, APLA, depression and cognitive dysfunction in SLE. Aim 1 of this study proposes to evaluate the relationships among depression and cognitive dysfunction among SLE patients with and without APLAs. Aim 2 of this investigation proposes to evaluate the contributions of APLA and MRI markers on depression and cognitive dysfunction. Diffusion Tensor Imaging (DTI) is an increasingly utilized MRI technology used to detect microscopic structural changes in otherwise normal appearing brain matter. Although this technique has proven useful in comparable CNS conditions, this technique has not been studied in SLE. We propose to compare the relative sensitivity of DTI and conventional MRI techniques (T2-weighted MRI) in relation to APLA, cognitive dysfunction and depression. Using this design we may begin to evaluate behavioral and serological markers, obtainable in the course of clinical care, that identify SLE patients with underlying CNS activity. In addition, we may provide preliminary evidence of a model of depression and cognitive dysfunction in SLE precipitated by underlying frontal CNS changes. This D & F project will provide pilot data and will lay the foundation for future studies evaluating neuropathological bases of cognitive function and depression in SLE. Such studies may guide the use of preventative interventions for SLE patients at risk for CVD.

这是开发和可行性 (D & F) 项目的申请，作为多学科项目的一部分临床研究中心提案。系统性红斑狼疮 (SLE) 是一种致残性自身免疫性疾病多器官系统受累的情况。最近，中枢神经系统（CMS）受累已成为 SLE 发病的主要原因。 SLE 患者发生脑血管病的风险增加疾病（CVD），而抗磷脂抗体（APLA）的存在是公认的危险因素。 APLA 还与认知功能障碍和磁共振成像 (MRI) 研究标记物相关，即使没有其他明显的神经系统症状。认知功能障碍和抑郁症属于其中之一神经精神系统性红斑狼疮 (SLE) 谱系中最常见的表现。在 SLE 中，这些病因尽管多发性硬化症的初步研究和 CVD 的现有文献，症状仍不清楚表明这些症状与 MRI 可见的额叶区域的结构变化有关研究。拟议的研究是对 MRI 标记物、APLA、抑郁症和 SLE 中的认知功能障碍。本研究的目标 1 旨在评估抑郁症之间的关系有或没有 APLA 的 SLE 患者的认知功能障碍。本次调查的目标 2 建议评估 APLA 和 MRI 标记对抑郁和认知功能障碍的贡献。扩散张量成像 (DTI) 是一种越来越多地使用的 MRI 技术，用于检测微观结构其他正常的大脑物质发生变化。尽管该技术已被证明有用与 CNS 条件相当，该技术尚未在 SLE 中进行研究。我们建议比较 DTI 和传统 MRI 技术（T2 加权 MRI）与 APLA、认知能力的相对敏感性功能障碍和抑郁症。使用这种设计，我们可以开始评估行为和血清学可以在临床护理过程中获得的标记物，用于识别具有潜在中枢神经系统活动的 SLE 患者。在此外，我们可以提供 SLE 抑郁和认知功能障碍模型的初步证据由潜在的额叶中枢神经系统变化引起。该 D & F 项目将提供试点数据并奠定为未来评估 SLE 认知功能和抑郁的神经病理学基础的研究奠定了基础。此类研究可以指导对有心血管疾病风险的系统性红斑狼疮患者采取预防性干预措施。