Abstract
Systemic lupus erythematosus (SLE) is a chronic inflammatory multi-system disorder that affects both central and peripheral nervous systems, leading to diverse neuropsychiatric manifestations. Cognitive impairment represents one of the most prevalent and debilitating neuropsychiatric symptoms in SLE, occurring in up to 80% of patients, with significant long-term clinical consequences. Despite its high prevalence, the underlying pathogenesis remains unclear, and its insidious onset and variable presentation often lead to underdiagnosis in clinical practice. Multimodal MRI techniques offer valuable insights into structural, functional, and metabolic abnormalities across both localized brain regions and global neural networks, facilitating comprehensive assessment of SLE-related cognitive dysfunction. Recent advances in SLE management have emphasized patient quality of life (QoL), and multimodal neuroimaging approaches may elucidate the relationship between cognitive impairment and QoL deterioration. Such strategies could improve early detection, therapeutic intervention, and preventive measures, ultimately enhancing socioeconomic outcomes and QoL for SLE patients with cognitive impairment.