Functional impairments in white matter syndrome of neuropsychiatric systemic lupus erythematosus are similar to those observed in patients with multiple sclerosis

Abstract

The functional impairments in NPSLE were similar to those of MS, although greater impairment of the functional systems of cerebellar, sensitivity, and sphincters occurred in MS cases, and greater symptoms of depression, anxiety, and headache also occurred in it.

Psychiatric manifestations in cerebrotendinous xanthomatosis

“…MS may cause cognitive disturbance or dementia and, less often, organic psychopathology encompassing behavioural/personality disturbance, mood/affective disorders or psychosis. 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104 Psychiatric syndromes, such as bipolar disorders and atypical psychosis, often unassociated with cognitive disturbance or dementia, have been described, and euphoria sclerotica is a characteristic psychosyndrome in MS. 83, 84, 85, 89, 91, 94, 95, 96, 99, 104, 105, 106, 107 Pure psychiatric presentation in MS is rare, as is the case for CTX. 83, 89, 91, 106, 107 Major depressive disorder, which often is prodromal leading to diagnostic delay, is overrepresented in MS patients, as are suicidal ideation, anxiety and sleep disorders, and they are mainly believed to be secondary to physical illness and/or disease-modifying treatment.…”

“…84, 85, 86, 87, 90, 93, 95, 96, 98, 99, 102, 104, 107, 108 Athough in MS a detrimental autoimmune process is the culprit, and not an enzymatic metabolic defect as in CTX, the relative infrequence, variability and complexity of psychiatric signs in both these diseases can be explained by the stochasticity and widespread nature of neural tissue damage, and the prerequisite of a cumulative effect and critical burden of white/grey matter loss or dysfunction. 85, 86, 90, 103, 104, 106, 107, 108, 109, 110, 111, 112, 113 Moreover, one can further classify the organic neuropsychiatric syndromes associated with CTX and MS, as primarily related to the integrity of subcortical myelinated systems, as is also reflected in similarities in their neuropsychological profiles with cognitive slowing, dysexecutive syndrome and attentional disorder. 107, 108, 109, 110, 111, 112 Indeed, the characteristics of dementia in the setting of CTX and MS merit their classification as white-matter dementias.…”