Neurofunctional Reversibility in Psoriasis Vulgaris After IL-17A Inhibition: A Resting-State fMRI and Neurocognitive Analysis

Jiayun Liu, Huiping Fan, Rui Sun, Yunyan Pang, Xiaojin Li, Qingsong Ma, Chen Xu, Dong Zhang, Weiyuan Ma Department of Dermatology, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, People’s Republic of ChinaCorrespondence: Dong Zhang, Department of Dermatology, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, People’s Republic of China, Tel +0086-536-3081272, Email [email protected] Weiyuan Ma, Department of Dermatology, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, People’s Republic of China, Tel +0086-536-3081272, Email [email protected]: Interleukin-17A (IL-17A) drives psoriasis and central nervous system neuroinflammation, but clinical research on whether IL-17A-targeted biotherapy modulates brain activity to improve neuropsychiatric outcomes in psoriasis is lacking. This study aims to investigate brain functional changes, cognitive impairment, and the effects of IL-17A monoclonal antibody therapy in psoriasis vulgaris.Patients and methods: Regular secukinumab treatment. Meanwhile, 20 healthy controls (HCs) matched in age and gender were enrolled. The patients underwent functional magnetic resonance imaging (fMRI) before treatment and 48 weeks after treatment. The healthy controls also had fMRI scans. It assessed clinical data, cognition/neuropsych status (MoCA, SDS, SAS), disease severity/quality of Life (PASI/DLQI), and brain function via rs-fMRI (ALFF/ReHo).Results: Compared to healthy controls, the psoriasis vulgaris patients showed increased ALFF in the frontal lobe, as well as increased frontal ReHo. The treatment group showed signal recovery in some brain regions. Patients before treatment had lower MoCA scores vs controls (P < 0.001)) and higher SAS/SDS scores (SAS, P < 0.0001; SDS, P < 0.05). Patients after treatment showed higher MoCA scores vs before treated (P < 0.05), similar to controls, with lower SAS scores (P < 0.0001) and reduced PASI/DLQI (P < 0.0001).Conclusion: Psoriasis is associated with brain dysfunction and neuropsychiatric symptoms. IL-17A antibody therapy improves skin symptoms, restores brain function, and alleviates neuropsychiatric issues vs untreated patients, supporting multidimensional treatment.Keywords: psoriasis vulgaris, rs-fMRI, brain function, cognitive impairment, IL-17A monoclonal antibody