ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1280

Abnormal Cortical Gyrification Patterns in Adolescents with Childhood-onset SLE: Early Associations with Perceived Fatigue

Diana Valdes Cabrera1, Tala El Tal2, Santiago Arciniegas1, Oscar Mwizerwa3, Asha Jeyanathan3, Lawrence Ng1, Paris Moaf1, Joanna Law4, Sarah Mossad5, Birgit Ertl-Wagner1, Ann Yeh1, Helen Branson1, Adrienne Davis6, Linda Hiraki1, Deborah Levy1, Busi Zapparoli7, Ashley Danguecan8 and Andrea Knight9, 1The Hospital for Sick Children, Toronto, ON, Canada, 2The Hospital For Sick Children & Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, The Hospital for Sick Children, Division of Rheumatology, Department of Paediatrics, University of Toronto, Toronto, ON, Canada, 3The Hospital for Sick Children, Division of Rheumatology, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Neurosciences and Mental Health, Research Institute, Toronto, ON, Canada, 4The Hospital for Sick Children, Division of Rheumatology, Department of Paediatrics, University of Toronto, Toronto, ON, Canada, 5Hospital for Sick Children, Toronto, ON, Canada, 6Division of Pediatric Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada, 7The Hospital for Sick Children, Etobicoke, ON, Canada, 8The Hospital for Sick Children, Department of Psychology, University of Toronto, Toronto, ON, Canada, 9Division of Rheumatology, The Hospital for Sick Children; Neurosciences and Mental Health, SickKids Research Institute; Department of Paediatrics, University of Toronto, Toronto, ON, Canada

Meeting: ACR Convergence 2024

Keywords: Cognitive dysfunction, Fatigue, Magnetic resonance imaging (MRI), Neuroimaging, Systemic lupus erythematosus (SLE)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 17, 2024

Title: Pediatric Rheumatology – Clinical Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Fatigue and brain fog are early complaints in adolescents with childhood-onset SLE (cSLE), who experience disease onset during a critical period of brain development. The typical neurodevelopmental process of folding or ‘gyrification’ of the cerebral cortex peaks during toddlerhood and decreases across puberty. Cortical folding patterns, as measured by the local gyrification index (LGI), may be altered in neurological disorders with childhood onset, such as autism, and related to neurodevelopmental pathology and cognitive and behavioral impairments, including executive dysfunction, fatigue, and depression. However, this metric has not yet been evaluated in cSLE cohorts. We aimed to (i) evaluate differences in LGI between adolescents with cSLE and healthy peers; and (ii) examine the relationship between LGI and fatigue while controlling for executive function.

Methods: T1-weighted MRI was cross-sectionally acquired at 3T from 53 youth with cSLE according to the ACR, SLICC or EULAR classification criteria, and 41 age/sex-matched healthy controls (HC) aged 11-17 years. Fatigue and executive dysfunction were self-reported from the Patient Reported Outcomes Measurement Information System (PROMIS) and the Behavior Rating Inventory of Executive Function (BRIEF-2, Global Executive Composite – GEC) assessment. LGI between-group differences across the whole brain cortex were calculated in Freesurfer with vertex-wise General Linear Models, controlling for age, sex, and surface area. Associations between LGI and fatigue were evaluated with regression analyses adjusted for age, education level, and GEC scores. Family-wise corrections for multiple comparisons were performed with permutation testing (10,000 permutations; p< 0.05, two-tailed).

Results: cSLE and HC groups displayed comparable age/sex distributions and GEC scores. When compared to controls, participants with cSLE exhibited higher fatigue (Table 1); and fatigue correlated with higher executive dysfunction in both cohorts (r=0.39-0.45, p< 0.01). Group analyses revealed higher LGI in 26 clusters spanning widespread bilateral regions of the frontal (clusters A and B) and temporal (cluster C) cortices in adolescents with cSLE when compared to HC (Fig. 1). For both groups, higher fatigue associated with lower LGI in clusters partially overlapping central/inferior frontal regions (Fig. 2). For lateral occipital regions, higher fatigue correlated with lower LGI in cSLE, while the inverse association (higher LGI) was observed in the HC group (Fig. 2).

Conclusion: Patients with cSLE exhibited higher fatigue levels and increased gyrification in frontotemporal regions compared to HC, suggesting atypical morphological brain development. Both cSLE and control groups showed shared relationships between fatigue and LGI in frontotemporal regions, and distinct relationships in occipital regions after adjusting for executive function. Given the neurophysiological links to mental fatigue in these regions, further longitudinal studies are needed to determine if abnormal gyrification is an early compensatory mechanism in response to SLE pathology or a driver of fatigue.

Supporting image 1

Table 1: Demographics and Clinical Characteristics of cSLE and HC groups. Higher PROMIS-Fatigue and GEC-BRIEF_2 scores mean greater fatigue / executive dysfunction. Thresholds were 1.5 SD above the normative mean. One cSLE participant was diagnosed with NPSLE.

Supporting image 2

Figure 1: cSLE versus HC brain regional group differences in local gyrification index (LGI, family-wise error corrected p<0.05). Higher LGI was observed in 26 significant clusters spanning widespread bilateral areas of the frontal cortex, mostly medial frontal regions (clusters A and B), and in the temporal cortex (cluster C) of adolescents with cSLE when compared to HC.

Supporting image 3

Figure 2: Regional local gyrification index (LGI) and fatigue associations in cSLE and HC cohorts (family-wise error corrected p<0.05). For both groups, higher fatigue was associated with lower LGI in clusters partially overlapping central/inferior frontal regions (purple lens). On the contrary, for lateral occipital regions, higher fatigue correlated with lower LGI in cSLE, while the inverse association (higher LGI) was observed in the HC group (cyan lens).


Disclosures: D. Valdes Cabrera: None; T. El Tal: None; S. Arciniegas: None; O. Mwizerwa: None; A. Jeyanathan: None; L. Ng: None; P. Moaf: None; J. Law: None; S. Mossad: None; B. Ertl-Wagner: Bayer Healthcare, 5, Siemens Healthineers, 3; A. Yeh: Alexion, 12, site PI clinical trial, Biogen, 5, horizon, 12, site PI clinical trial, Roche, 12, clinical trial site PI; H. Branson: None; A. Davis: None; L. Hiraki: Janssen, 2; D. Levy: AbbVie, 5, AstraZeneca, 5, Roche, 5, SOBI, 5; B. Zapparoli: None; A. Danguecan: None; A. Knight: Pfizer, 6.

To cite this abstract in AMA style:

Valdes Cabrera D, El Tal T, Arciniegas S, Mwizerwa O, Jeyanathan A, Ng L, Moaf P, Law J, Mossad S, Ertl-Wagner B, Yeh A, Branson H, Davis A, Hiraki L, Levy D, Zapparoli B, Danguecan A, Knight A. Abnormal Cortical Gyrification Patterns in Adolescents with Childhood-onset SLE: Early Associations with Perceived Fatigue [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/abnormal-cortical-gyrification-patterns-in-adolescents-with-childhood-onset-sle-early-associations-with-perceived-fatigue/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2024

ACR Meeting Abstracts - https://acrabstracts.org/abstract/abnormal-cortical-gyrification-patterns-in-adolescents-with-childhood-onset-sle-early-associations-with-perceived-fatigue/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology