Unknown Heart, Stroke & Blood NIHR-supported project Brain & Nervous System

Cognitive fatigue and dysfunction in systemic lupus erythematosus: an exploratory study on the underlying mechanisms and the role of physical activity

In plain English

AI plain-English summary

One in three people with lupus struggles with thinking, memory, and concentration—yet doctors do not know why, and have almost no treatments to offer. Systemic lupus erythematosus (SLE) is an autoimmune disease that attacks multiple organs, including the brain. Cognitive dysfunction—difficulty focusing, remembering, or making decisions—is one of the most common and disabling symptoms, but its underlying brain mechanisms remain poorly understood. This observational study will compare brain structure and function, using fMRI scans, in people with SLE who have cognitive problems, those who do not, and healthy controls. It will also measure physical activity levels with accelerometers to test whether an active lifestyle is linked to better cognitive function. If the research identifies specific brain changes tied to cognitive dysfunction, it could open the door to targeted therapies. If physical activity proves protective, it would offer a low-cost, accessible intervention that patients could start immediately. The findings could also reshape how clinicians monitor brain health in SLE, moving beyond symptom checklists to objective imaging and activity-based assessments.

View original technical description
Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease marked by fluctuating symptoms and multiple system involvement. SLE patients often experience neuropsychiatric disorders, such as anxiety/depression, headache, and cognitive dysfunction. Among them, cognitive dysfunction is one of the most prevalent (affecting 38% of all patients) and debilitating symptoms in SLE, with a profound socioeconomic impact. The precise causes of cognitive dysfunction in SLE are uncertain but may arise from structural/functional changes in the brain, which need to be better investigated using comprehensive neuroimaging methods. Additionally, there are still limited treatment options for cognitive dysfunction in SLE. In recent years, physical activity has been widely explored in the clinical management of symptom burden in SLE, showing positive effects in the control of the disease and improvement of quality life. However, it is currently unknown if having a physically active lifestyle associates with better cognitive function on SLE, warranting further investigation. The present project is an observational study that will collect data on cognitive function, brain structure and function and physical activity in individuals with SLE. Specifically, the project intends to explore underlying brain mechanisms associated with cognitive dysfunction in SLE; and the associations between physical activity/sedentary behaviour and cognitive function in SLE. Twenty four individuals with SLE and 12 healthy controls will attend The Institute of Sport at Manchester Metropolitan University, where they will undergo a comprehensive assessment of cognitive function, brain structural and functional magnetic resonance imaging (fMRI) scans, and will perform physical testing and assess their physical activity levels using accelerometry. Participants with SLE will be grouped by the presence/absence of cognitive dysfunction and be compared with healthy controls.

Researchers

Michelle Barraclough (Principal Investigator)

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Original classification

Rheumatic Musculoskeletal Diseases

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