Lupus & antiphospholipid syndrome
Role of combination immunotherapy in restoring brain synergistic functional connectivity in patients with systemic lupus erythematosus without overt neuropsychiatric manifestations
Authors' conclusion
Even without overt neuropsychiatric symptoms, patients with SLE exhibit impaired interhemispheric functional synergy that is partially reversed by combination immunosuppression, suggesting an early targetable brain pathway.
Study context
- Population
- Patients with SLE without overt neuropsychiatric manifestations and healthy controls
- Participants
- 140 / 22 / 30 / 50 / 94
- Exposure
- SLE vs healthy controls; SLE treatment subgroups vs healthy controls (HCs)
- SLEn = 140
- Treatment-naïven = 22
- GCn = 30
- GC combined with CTX and/or hydroxychloroquine (HCQ)n = 50
- HCsn = 94reference
- Outcome
- Interhemispheric connectivity: voxel-mirrored homotopic connectivity (VMHC)
Methodological detailsstratified analysis by treatment, resting-state functional MRI (voxel-mirrored homotopic connectivity (VMHC)), Gaussian random field corrected
- Stratified analysis by treatment
- Resting-state functional MRI (VMHC)
- Gaussian random field corrected
Main finding
As reported in the abstract
VMHC, SLE vs HCs
- SLE lower VMHC than HCs in bilateral superior temporal gyrus, medial superior frontal gyrus, calcarine fissure and surrounding cortex and middle occipital cortices (voxel p<0.005, cluster p<0.01, Gaussian random field corrected)
Observational data: associations, not effects.
Further findings
| Outcome | T |
|---|---|
| VMHC, post hoc subgroup comparisonsTreatment-naïve vs HCs · decreased in bilateral posterior central gyrus | −2.953 |
| VMHC, post hoc subgroup comparisonsGC vs HCs · decreased in posterior central gyrus | −2.999 |
| VMHC, post hoc subgroup comparisonsGC vs HCs · decreased in anterior cingulate/paracingulate gyrus | −2.999 |
| VMHC, post hoc subgroup comparisonsGC vs GC combined with CTX and/or HCQ · decreased in postcentral gyrus | −2.999 |
Correlation of VMHC with depression score
- Bilateral superior temporal gyrus VMHC vs depression score, rs (p=0.024)
- −0.250
- Medial superior frontal gyrus VMHC vs depression score, rs (p=0.026)
- −0.246
Correlation of VMHC with anxiety score
- Medial superior frontal gyrus VMHC vs anxiety score, rs (p=0.031)
- −0.239
VMHC across three SLE subgroups and HCs
- Postcentral/precentral gyrus, F
- 8.942
- Anterior cingulate/paracingulate gyrus, F
- 9.868
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Role of combination immunotherapy in restoring brain synergistic functional connectivity in patients with systemic lupus erythematosus without overt neuropsychiatric manifestations. Lupus Sci Med. Published 29 October 2025. doi:10.
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