Tract-based white matter hyperintensity patterns in patients with systemic lupus erythematosus using an unsupervised machine learning approach

Scientific Reports, vol. 12, pp. 21376

Abstract

Currently, little is known about the spatial distribution of white matter hyperintensities (WMH) in the brain of patients with Systemic Lupus erythematosus (SLE). Previous lesion markers, such as number and volume, ignore the strategic location of WMH. The goal of this work was to develop a fully-automated method to identify predominant patterns of WMH across WM tracts based on cluster analysis. A total of 221 SLE patients with and without neuropsychiatric symptoms from two different sites were included in this study. WMH segmentations and lesion locations were acquired automatically. Cluster analysis was performed on the WMH distribution in 20 WM tracts. Our pipeline identified five distinct clusters with predominant involvement of the forceps major, forceps minor, as well as right and left anterior thalamic radiations and the right inferior fronto-occipital fasciculus. The patterns of the affected WM tracts were consistent over the SLE subtypes and sites. Our approach revealed distinct and robust tract-based WMH patterns within SLE patients. This method could provide a basis, to link the location of WMH with clinical symptoms. Furthermore, it could be used for other diseases characterized by presence of WMH to investigate both the clinical relevance of WMH and underlying pathomechanism in the brain.

Authors 15

1. Theodor Rumetshofer corresponding

   Lund University

   Affiliation as printed

   Department of Clinical Sciences Lund/Diagnostic Radiology, Lund University, Lund, Sweden. theodor.rumetshofer@med.lu.se

   Department of Clinical Sciences Lund/Diagnostic Radiology, Lund University, Lund, Sweden

2. Francesca Inglese Aachen Department of Radiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

3. Jeroen de Bresser Aachen Department of Radiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

4. Peter Mannfolk

   Skåne University Hospital

   Affiliation as printed

   Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden

5. Olof T. Strandberg

   Lund University

   Affiliation as printed

   Department of Clinical Sciences Malmö/ Clinical Memory Research Unit, Lund University, Lund, Sweden

6. Andreas Jönsen

   Lund University · Skåne University Hospital

   Affiliation as printed

   Department of Clinical Sciences Lund/ Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden

7. Anders A Bengtsson

   Lund University · Skåne University Hospital

   Affiliation as printed

   Department of Clinical Sciences Lund/ Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden

8. Markus Nilsson

   Lund University

   Affiliation as printed

   Department of Clinical Sciences Lund/Diagnostic Radiology, Lund University, Lund, Sweden

9. Linda Knutsson

   Kennedy Krieger Institute · Johns Hopkins University · Lund University · Johns Hopkins Medicine

   Affiliation as printed

   Department of Medical Radiation Physics, Lund University, Lund, Sweden

   F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA

   Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

10. Jimmy Lätt

    Skåne University Hospital

    Affiliation as printed

    Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden

11. Gerda M. Steup‐Beekman Aachen Department of Rheumatology, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

12. Tom W. J. Huizinga Aachen Department of Rheumatology, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

13. Mark A. van Buchem Aachen Department of Radiology, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

14. Itamar Ronen

    Brighton and Sussex Medical School · University of Brighton

    Affiliation as printed

    Clinical Imaging Science Center, Brighton and Sussex Medical School, University of Brighton, Brighton, UK

15. Pia C. Sundgren

    Lund University · Skåne University Hospital

    Affiliation as printed

    Department of Clinical Sciences Lund/Diagnostic Radiology, Lund University, Lund, Sweden

    Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden

    Lund University BioImaging Center, Lund University, Lund, Sweden