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Objectives <p>Knee osteoarthritis (KOA), a degenerative joint disease marked by chronic pain, is associated with systemic inflammation that may extend to neurocognitive dysfunction. While chronic low-grade inflammation in KOA has been implicated in mild cognitive impairment (MCI), a prodromal stage of dementia, the mediating role of inflammation in brain functional reorganization remains unclear.</p> Methods <p>This study integrated neuroimaging, inflammatory biomarkers, and machine learning to investigate inflammation-mediated brain functional alterations in 63 KOA patients with/without MCI. Serum levels of pro-inflammatory cytokines (IL-6, TNF-α) and resting-state fMRI data were analyzed using voxel-wise Regional Homogeneity (ReHo) and Amplitude of Low-Frequency Fluctuation (ALFF).</p> Results <p>Comparisons across healthy controls, KOA-MCI, and KOA-non-MCI groups identified MCI-linked functional alterations in the medial prefrontal cortex (mPFC), precuneus, and superior temporal gyrus. Mediation analysis revealed that mPFC ReHo significantly mediated the relationship between elevated IL-6 and cognitive decline. Machine learning models incorporating ReHo features from mPFC demonstrated robust classification of MCI status (AUC: 0.87), validated in an external dataset.</p> Conclusion <p>Our findings suggest that IL-6-driven mPFC dysfunction is a potential pathway linking KOA-related inflammation to MCI, while highlighting the combined utility of ReHo/ALFF metrics in mPFC, precuneus, and temporal regions as potential neuroimaging biomarkers. This multimodal approach advances understanding of neuroinflammatory mechanisms in osteoarthritis and provides a framework for early detection of cognitive vulnerability in KOA populations.</p>

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Inflammation-mediated regional brain alterations associated with mild cognitive impairment in knee osteoarthritis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月26日

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  • Chao Li,
  • Congqiang Hao,
  • Kechong Zhou,
  • Peng Zhang,
  • Quan Sun,
  • Zhengxi Li

摘要

Objectives

Knee osteoarthritis (KOA), a degenerative joint disease marked by chronic pain, is associated with systemic inflammation that may extend to neurocognitive dysfunction. While chronic low-grade inflammation in KOA has been implicated in mild cognitive impairment (MCI), a prodromal stage of dementia, the mediating role of inflammation in brain functional reorganization remains unclear.

Methods

This study integrated neuroimaging, inflammatory biomarkers, and machine learning to investigate inflammation-mediated brain functional alterations in 63 KOA patients with/without MCI. Serum levels of pro-inflammatory cytokines (IL-6, TNF-α) and resting-state fMRI data were analyzed using voxel-wise Regional Homogeneity (ReHo) and Amplitude of Low-Frequency Fluctuation (ALFF).

Results

Comparisons across healthy controls, KOA-MCI, and KOA-non-MCI groups identified MCI-linked functional alterations in the medial prefrontal cortex (mPFC), precuneus, and superior temporal gyrus. Mediation analysis revealed that mPFC ReHo significantly mediated the relationship between elevated IL-6 and cognitive decline. Machine learning models incorporating ReHo features from mPFC demonstrated robust classification of MCI status (AUC: 0.87), validated in an external dataset.

Conclusion

Our findings suggest that IL-6-driven mPFC dysfunction is a potential pathway linking KOA-related inflammation to MCI, while highlighting the combined utility of ReHo/ALFF metrics in mPFC, precuneus, and temporal regions as potential neuroimaging biomarkers. This multimodal approach advances understanding of neuroinflammatory mechanisms in osteoarthritis and provides a framework for early detection of cognitive vulnerability in KOA populations.