Initial assessment of blood-brain barrier permeability alterations and associated clinical characteristics in patients with primary Sjögren's syndrome: Insights from DCE-MRI
Objective To quantitatively evaluate blood-brain barrier (BBB) permeability alterations in primary Sj & ouml;gren's syndrome (pSS) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and their associations with clinical immune-inflammatory indicators. Methods In this retrospective study, 19 pSS patients and 23 controls underwent 3.0 T DCE-MRI. BBB permeability was quantified using voxel-wise K-trans maps on the Patlak model. Whole-brain voxel-wise t-tests were conducted with age and sex as covariates, followed by threshold-free cluster enhancement (TFCE) (1000 permutations, P_TFCE < 0.05) and exploratory uncorrected analysis (P_uncorr < 0.005, cluster >= 50 voxels). Whole-brain and ROI K-trans values were analyzed by ANCOVA with the same covariates. Correlations between regional K-trans and clinical markers were evaluated by Pearson/Spearman tests and multivariate regression. Results Voxel-wise analysis using TFCE correction (P_TFCE < 0.05) identified significantly elevated K-trans values in the right cerebellum, whereas exploratory uncorrected analysis (P_uncorr < 0.005, cluster size >= 50 voxels) revealed increases in right cerebellum, right temporal pole of the middle temporal gyrus, and right inferior temporal gyrus. No significant differences were observed in whole-brain mean K-trans (P > 0.05) or ROI K-trans (all P_uncorr > 0.05). Uncorrected correlations indicated positive associations between regional mean K-trans and serum globulin, IgM, ESR, and platelets; only limbic K-trans remained significantly correlated with globulin after FDR correction. Multivariate regression confirmed globulin and ESR as independent predictors of regional K-trans elevation. Conclusion This study provides the first in vivo DCE-MRI evidence of focal BBB permeability alterations in pSS, potentially associated with immune activation and systemic inflammation. These preliminary findings suggest that DCE-MRI may enable early detection of subclinical central nervous system involvement in pSS and provide insights into its underlying neuroimmunological mechanisms.
基金：
The Youth Talent of Ten Thousand Scientists Program of Yunnan Province [YNWR-QNBJ-2018-152]; Kunming Medical University 2025 Graduate Education Innovation Fund [2025S042]; Yunnan Province Clinical Center for Skin Immune Diseases [YWLCYXZX2023300076]; Funding of Yunnan Provincial Health Science and Technology Plan [2017NS051]; National Natural Science Foundation of China [32270947, 81760296, 82060259]; Yunnan Applied Basic Research Projects, Kunming Medical University Union Special Fund [202301AY070001-159]; Yunnan Province Special Project for Famous Medical Talents of the "Ten Thousand Talents Program" [YNWRMY-2018-040, YNWR-MY-2018-041]; Doctoral Research Fund Project of the First Affiliated Hospital of Kunming Medical University (newly appointed doctoral research specialty) [2023BS018]; Yunnan Province High-level health technical talents (leading talents) [L-2019004, L-2019011]; Bethune Charitable Foundation [PAYJ-043]; Funding of Ministry of Science and Technology of Yunnan Province [2018ZF016]; Yunnan Province Clinical Research Center for Skin Immune Diseases [2019ZF012]; 535 Talent Project of First Affiliated Hospital of Kunming Medical University [2022535Q01]
第一作者机构：[1]Kunming Med Univ, Dept Rheumatol & Immunol, Affiliated Hosp 1, Kunming 650032, Yunnan, Peoples R China
共同第一作者：
通讯作者：
通讯机构：[2]Zhejiang Univ, Affiliated Mental Hlth Ctr, Sch Med, Hangzhou 310058, Zhejiang, Peoples R China[3]Zhejiang Univ, Hangzhou Peoples Hosp 7, Sch Med, Hangzhou 310058, Zhejiang, Peoples R China
推荐引用方式(GB/T 7714)：
Liu Zhicheng,Yang Yifan,Liu Shuang,et al.Initial assessment of blood-brain barrier permeability alterations and associated clinical characteristics in patients with primary Sjögren's syndrome: Insights from DCE-MRI[J].CLINICAL RHEUMATOLOGY.2025,doi:10.1007/s10067-025-07806-0.
APA：
Liu, Zhicheng,Yang, Yifan,Liu, Shuang,Zhang, Guofang,Zhao, Ruotong...&Xu, Jian.(2025).Initial assessment of blood-brain barrier permeability alterations and associated clinical characteristics in patients with primary Sjögren's syndrome: Insights from DCE-MRI.CLINICAL RHEUMATOLOGY,,
MLA：
Liu, Zhicheng,et al."Initial assessment of blood-brain barrier permeability alterations and associated clinical characteristics in patients with primary Sjögren's syndrome: Insights from DCE-MRI".CLINICAL RHEUMATOLOGY .(2025)
