Functional imaging reveals cerebral microvascular dysfunction in primary antiphospholipid syndrome

Author: Mameli A, Indovina L, Cocciolillo F, Serra A, Marongiu F, Barcellona D.

Editor's Choice
Journal of the Neurological Sciences | Functional imaging reveals cerebral microvascular dysfunction in primary antiphospholipid syndrome: Pathophysiologic insights and translational implications, 2026

Article Link: https://doi.org/10.1016/j.jns.2026.125750

A new study highlights the often-overlooked burden of cerebral microvascular involvement in primary antiphospholipid syndrome (PAPS), even in patients without overt neurological events. Using Tc-99m ECD SPECT imaging, the researchers identified consistent cortical perfusion abnormalities that were not detected by conventional MRI, suggesting subclinical brain involvement.

The findings show bilateral frontoparietal hypoperfusion in PAPS patients compared with matched controls, with a higher burden of microvascular dysfunction observed in those with venous APS than arterial disease. By integrating functional neuroimaging with standardized antiphospholipid antibody profiling, the study offers a more refined phenotypic characterisation of PAPS and sheds light on immune-mediated mechanisms underlying cognitive and neuropsychiatric symptoms.

Read the full article for insight into how functional imaging can reveal early cerebral dysfunction in PAPS and why this approach may open new avenues for earlier intervention and personalised management.