Diffusion kurtosis imaging (DKI) and neurite orientation dispersion and density imaging (NODDI) provide more comprehensive and informative perspective on microstructural alterations of cerebral white matter (WM) than single-shell diffusion tensor imaging (DTI), especially in the detection of crossing fiber. However, studies on systemic lupus erythematosus patients without neuropsychiatric symptoms (non-NPSLE patients) using multi-shell diffusion imaging remain scarce. Totally 49 non-NPSLE patients and 41 age-, sex-, and education-matched healthy controls underwent multi-shell diffusion magnetic resonance imaging. Totally 10 diffusion metrics based on DKI (fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity, mean kurtosis, axial kurtosis and radial kurtosis) and NODDI (neurite density index, orientation dispersion index and volume fraction of the isotropic diffusion compartment) were evaluated. Tract-based spatial statistics (TBSS) and atlas-based region-of-interest (ROI) analyses were performed to determine group differences in brain WM microstructure. The associations of multi-shell diffusion metrics with clinical indicators were determined for further investigation. TBSS analysis revealed reduced FA, AD and RK and increased ODI in the WM of non-NPSLE patients (P < 0.05, family-wise error corrected), and ODI showed the best discriminative ability. Atlas-based ROI analysis found increased ODI values in anterior thalamic radiation (ATR), inferior frontal-occipital fasciculus (IFOF), forceps major (F_major), forceps minor (F_minor) and uncinate fasciculus (UF) in non-NPSLE patients, and the right ATR showed the best discriminative ability. ODI in the F_major was positively correlated to C3. This study suggested that DKI and NODDI metrics can complementarily detect WM abnormalities in non-NPSLE patients and revealed ODI as a more sensitive and specific biomarker than DKI, guiding further understanding of the pathophysiological mechanism of normal-appearing WM injury in SLE.

中文翻译：

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无神经精神症状的系统性红斑狼疮患者白质的微观结构变化：多壳扩散成像研究


扩散峰度成像 (DKI) 和神经突定向色散和密度成像 (NODDI) 比单壳扩散张量成像 (DTI) 提供更全面、信息更丰富的脑白质 (WM) 微观结构变化视角，特别是在交叉纤维的检测方面。然而，使用多壳扩散成像对无神经精神症状的系统性红斑狼疮患者（非 NPSLE 患者）进行的研究仍然很少。总共 49 名非 NPSLE 患者和 41 名年龄、性别和教育程度匹配的健康对照接受了多壳扩散磁共振成像。基于DKI（分数各向异性、平均扩散率、轴向扩散率、径向扩散率、平均峰度、轴向峰度和径向峰度）和NODDI（神经突密度指数、方向色散指数和各向同性扩散室的体积分数）总共评估了10个扩散指标。进行基于束的空间统计 (TBSS) 和基于图集的感兴趣区域 (ROI) 分析，以确定大脑 WM 微观结构的组间差异。确定多壳扩散指标与临床指标的关联以供进一步研究。 TBSS分析显示，非NPSLE患者的WM中FA、AD和RK减少，ODI增加（P < 0.05，家庭误差已纠正），并且ODI表现出最好的辨别能力。基于图谱的 ROI 分析发现，非 NPSLE 患者中丘脑前部辐射 (ATR)、额枕下束 (IFOF)、大镊子 (F_major)、小镊子 (F_minor) 和钩束 (UF) 的 ODI 值增加，并且正确的 ATR 显示出最好的判别能力。 F大调中的ODI与C3呈正相关。 这项研究表明，DKI 和 NODDI 指标可以互补检测非 NPSLE 患者的 WM 异常，并揭示 ODI 是比 DKI 更敏感和特异的生物标志物，指导进一步了解 SLE 中正常表现的 WM 损伤的病理生理机制。