Influence of sex and systemic lupus erythematosus disease status on cerebral cortex structure

OBJECTIVE: To investigate the main and interactive effects of sex and disease diagnosis on cortical morphology in systemic lupus erythematosus (SLE), providing neuroimaging evidence for sex-by-disease interactive mechanisms underlying structural brain alterations. METHODS: A cross-sectional study design was used to recruit participants. Structural MRI scans were acquired and processed using surface-based morphometry (SBM) to extract cortical thickness (CT), gyrification index (GI), fractal dimension (FD) and sulcal depth (SD) within predefined regions of interest. Two-way analysis of variance assessed main effects and 'sex×diagnosis' interactions (Holm-Bonferroni corrected). Correlation analyses were performed between these structural metrics and SLE disease activity/psychological assessment scores in areas showing significant interactions. RESULTS: =14.1650, p=0.0313), with female SLE>male SLE (pmale SLE (p=0.0003). Diagnostic main effects (HC>SLE) were observed extensively for CT across both hemispheres. No significant correlations emerged between disease activity/psychological assessment scores and structural parameters in interaction-significant regions. CONCLUSION: This study provides novel evidence for sex-by-diagnosis interactive effects in the neuropathological mechanisms of SLE. Sex and SLE disease status have both independent and interacting impacts on cerebral cortical structure. TRIAL REGISTRATION NUMBER: NCT00703742.