Mark W. DiFrancesco, PhD, Cincinnati Children’s Hospital Medical Center

“Imaging the Blood-Brain Barrier in Childhood-Onset Neuropsychiatric Lupus”

2013 Michael Jon Barlin Pediatric Lupus Research Program

This grant award is presented in memory of Kassie McMullin Biglow and is made possible in part by funds provided by the Greater Ohio Chapter of the Lupus Foundation of America.

Neurological or psychiatric conditions that develop in people with lupus are referred to as neuropsychiatric lupus. Neuropsychiatric lupus is the least understood manifestation of lupus and may affect children more severely than adults. It often results in impairment of cognitive (thinking) function, which is also known as neurocognitive deficit. Formal testing can detect changes in cognitive function of people with neuropsychiatric lupus. However, the cause and pathophysiology of neurocognitive deficit is not completely understood. Previous studies have shown that neurocognitive deficit associated with neuropsychiatric lupus leads to gray matter volume loss in regions of the brain. 

In neuropsychiatric lupus, it is proposed that damage may be caused by exposure to circulating autoantibodies (antibodies against one's self) due to breakdown of the blood-brain barrier. The blood-brain barrier is a wall of capillaries that protects the brain from foreign substances in the blood that may cause injury. In the past, techniques used to assess the integrity of the blood-brain barrier have been indirect and risky. Dr. DiFrancesco and his team will study a new noninvasive imaging technique that allows direct regional measurement of blood-brain barrier integrity. The researchers will relate this measure to antibody assessments, medication use, and disease status of people with neuropsychiatric lupus.  

This study will markedly impact lupus research, especially in children, by demonstrating a noninvasive imaging biomarker specific to the blood-brain barrier. The imaging technique will allow for safe repeated assessment of this region of the brain over time, providing a better understanding of how neuropsychiatric lupus progresses. 

Learn more about Dr. DiFrancesco’s research on neuropsychiatric lupus in children.