Association of Blood–Brain Barrier Function With Disease Activity and Cognitive Function in Systemic Lupus Erythematosus Patients
Bibliographic record
Abstract
ABSTRACT Background Disruption of the blood–brain barrier ( BBB ) is an important mechanism in the pathogenesis of neuropsychiatric systemic lupus erythematosus ( NPSLE ), potentially influencing disease progression and cognitive function. Purpose To investigate voxel‐wise BBB permeability differences among NPSLE , non‐ NPSLE , and healthy controls ( HC ) using dynamic contrast‐enhanced MRI ( DCE ‐ MRI ), and explore associations with disease activity and cognitive function. Study Type Multicenter, cross‐sectional study. Subjects 22 NPSLE patients, 24 non‐NPSLE patients, and 27 age‐ and sex‐matched HC. Field Strength/Sequence 3.0 Tesla, GE: 3D T1‐FSPGR, DCE‐LAVA‐Flex sequences; Philips: 3D T1‐FFE, eTHRIVE sequences. Assessment Post‐processing of DCE‐MRI images was conducted to calculate the volume transfer constant (K trans ) and plasma volume fraction (V p ) maps, which were transformed to Montreal Neurological Institute space. Brain regions were defined using the Anatomical Automatic Labeling (AAL) atlas. Group differences among NPSLE, non‐NPSLE, and HC were assessed. Mean K trans /V p values from suprathreshold clusters were evaluated for associations with the Disease Activity Index (SLEDAI) and Montreal Cognitive Assessment (MoCA) scores. Mean K trans /V p from corresponding AAL regions was extracted for further validation of the observed correlations. Statistical Tests Voxel‐wise ANOVA with Tukey's HSD test; Spearman correlation and linear regression. Threshold: Voxel‐wise p < 0.001, cluster size > 20; group comparisons p < 0.05. Results A significantly elevated K trans was observed in the right caudate of NPSLE patients compared to non‐ NPSLE patients, and hippocampal K trans was significantly higher in NPSLE than both non‐ NPSLE and HC . Both NPSLE and non‐ NPSLE patients exhibited widespread significant increases in V p compared to HC . In the entire SLE cohort, right caudate K trans was positively associated with SLEDAI ( ρ = 0.43, R 2 = 0.18) and negatively associated with MoCA scores ( ρ = −0.35, R 2 = 0.12) after adjusting for confounding factors. Data Conclusion This study provided voxel‐level evidence linking regional BBB leakage to both disease activity and cognitive impairment in SLE. Evidence Level 2. Technical Efficacy Stage 2.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".