Characterization of brain dysfunction with multi-modal functional neuroimaging in patients with SLE and cognitive impairment

Systemic lupus erythematosus (SLE) is an autoimmune disease which can cause inflammation and damage to any part of the body. It affects 1:2000 people, women nine times more frequently than men, usually during the most productive time of their lives. Consequently, there is a significant social and economic cost associated with it. Involvement of the central nervous system (brain and spinal cord) by SLE results in a variety of neurological and psychiatric problems. Frequently, there is disturbance of normal cognitive function (e.g. the ability to think clearly, remember recent and past events and organize everyday tasks) which is called cognitive dysfunction ("lupus fog"). It is one of the least understood features of the illness despite its negative impact on daily function and quality of life. Dr. Hanly, who has conducted several research projects in this area, plans a study with experts in neuropsychology and neuroimaging to learn more about why lupus patients suffer from cognitive dysfunction. Patients attending the Lupus clinic at the Queen Elizabeth II Health Sciences Center in Halifax will be invited to undergo clinical testing for cognitive dysfunction. On the same day, brain imaging studies using magnetic resonance imaging (MRI) and magnetoencephalography (MEG) will be performed to assess information flow through brain networks, something that is required for normal cognitive functioning. The function of the blood-brain-barrier, a structure the protects the brain by controlling which components of the blood diffuse into the brain, will also be assessed. The proposed studies have not previously been done in SLE and should provide new information on why lupus patients have cognitive difficulties. The results should lead to improvements in the diagnosis and treatment of this distressing condition. The investigators are well established researchers, who bring diverse and complementary skills to address this important area of clinical need for SLE patients.