Volume and distribution of white matter hyperintensities in rheumatoid arthritis and ulcerative colitis patients.

Brain white matter disruptions have been implicated in contributing to fatigue, brain fog and other central symptoms commonly reported in inflammatory diseases. In this study, we included 252 RA patients with 756 age and sex matched controls and 240 UC patients with 720 age and sex matched controls using the UK Biobank imaging dataset. We looked for differences in total volume of white matter hyperintensities (WMH) between patients compared to controls. Then, using voxelwise analysis, we explored the spatial distribution of these white matter hyperintensities and differences in these between patients and controls and between disease groups. A significantly higher volume of WMH was observed in both the RA (p = 1.9 × 10 ^-8 , β =  - 0.36, 95% CI =  - 0.48, - 0.23) and UC (p = 0.003, β =  - 0.18 95% CI =  - 0.31, - 0.06) patients compared to their respective control groups. Voxelwise analysis revealed only a small cluster of RA associated WMH compared to controls. These results indicate an increased risk of white matter hyperintensities in patients with RA and UC. These findings help quantify the effect of inflammation from autoimmune diseases on cerebrovascular health and white matter integrity.
Competing Interests: Declarations. Competing interests: Jennifer Cox is an industry funded PhD student funded by GlaxoSmithKline and an employee of Johnson & Johnson. GSK and Johnson & Johnson had no role in the design or conduct of the study. Dr. de Groot is a former employee of, and holds shares in GlaxoSmithKline (GSK). GSK had no role in the design or conduct of the study. Dr. Kempton was funded by an MRC Career Development Fellowship (grant MR/J008915/1). Dr. Williams has received research funding from Bionomics, Eli Lilly, the Engineering and Physical Sciences Research Council, GlaxoSmithKline, Johnson & Johnson, Lundbeck, the National Institute of Health Research, Pfizer, Takeda, and Wellcome Trust. The authors acknowledge financial support from the Wellcome Trust and the Engineering and Physical Sciences Research Council for the King’s Medical Engineering Centre and the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed here are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. The other authors report no financial relationships with commercial interests. Ethics approval and consent to participate: The UK Biobank has approval from the North West Multi-centre Research Ethics Committee (MREC) as a Research Tissue Bank (RTB) approval. This research was done under the RTB approval and separate ethical clearance was not required. The UK Biobank Ethics and Governance Council (EGC) was established as an independent guardian of the UK Biobank Ethics and Governance Framework (EGF). All participant materials, including the informed consent form, have been developed and are monitored under this framework. All data received from the UK Biobank is anonymised and additional consent for this research was not required.
(© 2024. The Author(s).)