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Background <p>Chronic pain and psychiatric comorbidities in juvenile idiopathic arthritis (JIA) persist even during disease remission, suggesting central nervous system (CNS) alterations. This study used proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS) to investigate neurometabolic changes in the right hippocampus of JIA patients across active and inactive disease phases.</p> Methods <p>A cohort of 248 JIA patients (61 treatment-naïve patients with active JIA and 187 patients with inactive JIA) and 57 healthy controls (HCs) underwent <sup>1</sup>H-MRS of the right hippocampus. Metabolite ratios of total N-acetylaspartate (tNAA), total choline (tCho), myo-inositol (mI), glutamate (Glu), and glutamate-glutamine complex (Glx) relative to total creatine (tCr) were quantified. Associations with systemic inflammation (ESR and CRP) and clinical indices (JADAS-27 and CHAQ) were evaluated.</p> Results <p>Compared with HCs, both JIA groups showed elevated mI/tCr and reduced Glu/tCr and Glx/tCr in the inactive JIA group (all, <i>P</i> &lt; 0.05). mI/tCr was positively correlated with ESR (rho = 0.269) and CRP (rho = 0.287) in active JIA patients. However, the results did not survive the rigid multiple correction. Notably, tNAA/tCr, tCho/tCr, Glu/tCr and Glx/tCr showed no significant correlations with systemic inflammation and clinical indices for treatment-naïve and inactive JIA patients.</p> Conclusions <p>Sustained hippocampal neuroinflammation (indicated by elevated mI/tCr) and the subsequent glutamatergic synaptic dysfunction (indicated by reduced Glu/tCr and Glx/tCr) were identified in JIA patients. Peripheral inflammation may drive microglial activation during active disease, highlighting the hippocampus as a vulnerable CNS target in chronic inflammatory states.</p>

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Sustained hippocampal neuroinflammation and subsequent glutamatergic dysfunction in juvenile idiopathic arthritis: evidence from proton magnetic resonance spectroscopy (1H-MRS)

  • 期刊论文

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  • 发表日期：

    2025年12月30日

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  • Haiwei Han,
  • Yifei Weng,
  • Shumu Yang,
  • Chengkun Han,
  • Cuili Yi,
  • Hua Wu,
  • Jihong Xiao

摘要

Background

Chronic pain and psychiatric comorbidities in juvenile idiopathic arthritis (JIA) persist even during disease remission, suggesting central nervous system (CNS) alterations. This study used proton magnetic resonance spectroscopy (1H-MRS) to investigate neurometabolic changes in the right hippocampus of JIA patients across active and inactive disease phases.

Methods

A cohort of 248 JIA patients (61 treatment-naïve patients with active JIA and 187 patients with inactive JIA) and 57 healthy controls (HCs) underwent 1H-MRS of the right hippocampus. Metabolite ratios of total N-acetylaspartate (tNAA), total choline (tCho), myo-inositol (mI), glutamate (Glu), and glutamate-glutamine complex (Glx) relative to total creatine (tCr) were quantified. Associations with systemic inflammation (ESR and CRP) and clinical indices (JADAS-27 and CHAQ) were evaluated.

Results

Compared with HCs, both JIA groups showed elevated mI/tCr and reduced Glu/tCr and Glx/tCr in the inactive JIA group (all, P < 0.05). mI/tCr was positively correlated with ESR (rho = 0.269) and CRP (rho = 0.287) in active JIA patients. However, the results did not survive the rigid multiple correction. Notably, tNAA/tCr, tCho/tCr, Glu/tCr and Glx/tCr showed no significant correlations with systemic inflammation and clinical indices for treatment-naïve and inactive JIA patients.

Conclusions

Sustained hippocampal neuroinflammation (indicated by elevated mI/tCr) and the subsequent glutamatergic synaptic dysfunction (indicated by reduced Glu/tCr and Glx/tCr) were identified in JIA patients. Peripheral inflammation may drive microglial activation during active disease, highlighting the hippocampus as a vulnerable CNS target in chronic inflammatory states.