RT Journal Article
SR Electronic
T1 Effect of anti-P ribosomal and anti-NR2 antibodies on depression and cognitive processes in SLE: an integrated clinical and functional MRI study
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP e001005
DO 10.1136/lupus-2023-001005
VO 10
IS 2
A1 Chessa, Elisabetta
A1 Piga, Matteo
A1 Perra, Alessandra
A1 Pintus, Elisa
A1 Porcu, Michele
A1 Serafini, Cristina
A1 Congia, Mattia
A1 Angioni, Maria Maddalena
A1 Naitza, Micaela Rita
A1 Floris, Alberto
A1 Mathieu, Alessandro
A1 Saba, Luca
A1 Carta, Mauro Giovanni
A1 Cauli, Alberto
YR 2023
UL http://lupus.bmj.com/content/10/2/e001005.abstract
AB Objectives To explore the effects of anti-ribosomal P protein (anti-P) and anti-N-methyl-D-aspartic acid receptor subunit 2 (anti-NR2) autoantibodies on depression and cognitive dysfunction and their relationships with functional brain connectivity in SLE.Methods This cross-sectional study included adult patients who fulfilled the American College of Rheumatology/European Alliance of Associations for Rheumatology 2019 SLE criteria. Anti-P and anti-NR2 were quantified using ELISA. A 1-hour battery of neuropsychological testing interpreted by a neuropsychologist explored depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D), cognitive domains and quality of life (SF-12). Resting-state functional connectivity (rs-fc) MRI analysis was performed within 1 month, and region-of-interest to region-of-interest (ROI-to-ROI) analyses with the graph theory were performed.Results Thirty-three patients with SLE (9% male) were enrolled, mean age (SD) of 43.5 (14) years and median disease duration of 10.4 years (2.9–25.4). Anti-P was positive in 6 (18.2%) and anti-NR2 in 14 (42.4%) patients. Depressive symptoms were found in 14 (42.4%) patients using the CES-D (range 0–51). After correction for age, disease duration, disease activity and white matter lesion load, the CES-D score was independently associated with anti-P serum level (β=0.32; p=0.049) and prednisone daily dose (β=0.38; p=0.023). Nineteen patients (57.6%) showed at least a cognitive test alteration, but no significant association with autoantibodies was found. The rs-fc MRI analysis revealed an independent association between the anti-P serum levels and many altered brain ROI properties but no anti-NR2 and prednisone effects on the cerebral network.Conclusions Anti-P was associated with brain network perturbation, which may be responsible for depressive symptoms in patients with SLE.Data are available upon reasonable request.