Gradient of brain perfusion variation predicts thrombosis risk for patients with systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that can lead to intracranial thrombosis. Early detection and intervention are crucial for improving prognosis. However, misdiagnosis often occurs due to the lack of specificity in clinical symptoms and atypical nature of brain imaging. Method: We engaged a cohort of 36 SLE patients and 45 normal controls (NC). First, CBF values of brain were compared between patients and NC. Based on the normative perfusion pattern, gradient of CBF variation was obtained for each patient. Then, the significance of the correspondence between gradient of CBF variation and immunity indices were estimated using correlation analysis. Finally, moderation analysis was performed to test whether cognitive status of patients could moderate the relationship between gradient of CBF variation and immunity indices. Results: SLE patients displayed abnormal CBF alterations with increase distributed in left putamen and decrease distributed in right superior temporal gyrus. We found that gradient of CBF variation of these brain regions showed significant correlations with anti-cardiolipin antibody IgM in patients. When Mini-mental state examination (MMSE) score was used as the moderator, we observed no significant interaction between gradient of CBF variation and MMSE. Conclusion: CBF perfusion of SLE patients can be severely disrupted. The gradient of CBF variation in patients has a predictive effect on thrombosis formation. And this predictive power cannot be affected by patients’ cognition status.