Ab0410 cognitive Dysfunction in Primary Sjögren’s Syndrome and Systemic Lupus Erythematosus

Abstract

Background:Primary Sjögren’s syndrome (pSS) and systemic lupus erythematosus (SLE) share several clinical manifestations including neurological involvement. Cognitive dysfunction is a common neuropsychiatric manifestation in both, but evaluation and diagnosis is often challenging and delayed. The Automated Neuropsychological Assessment Metrics (ANAM) is a computerized cognitive screening tool that does not need specialized personnel to apply and is less time consuming than other tests.Objectives:Assess cognitive function of SLE and pSS patients with a computer-based tool (ANAM) in a single rheumatology clinic, compare its performance, and record their clinical and demographic characteristicsMethods:We recruited patients from the rheumatology clinic of the UANL University Hospital who met the pSS 2002 AECG or ACR-EULAR 2016 classification criteria and SLE patients fulfilling SLICC 2012 criteria. We defined mild cognitive impairment as 1 to 1.9 SD below controls, and moderate-severe cognitive impairment as 2 SD or more below the comparison group (subjects matched by age, sex, ethnicity and educational level by the ANAM program) as previously employed in SLE.Percentages were used for categorical variables and means (±SD) for numerical ones. To observe differences between groups, chi square and Student´s t were used,p<0.05 was considered significant.Results:A significant difference was observed in the total ANAM score between SLE and pSS patients (Table 1). In SLE, the most affected domains were simple reaction time, code substitution and delayed memory; in pSS patients, the most affected domains were inhibition and spatial work memory (Table 2).Table 1.Differences in ANAM performance between pSS and SLE.VariablepSSmean, (SD)SLEmean, (SD)pFemale, %92.293.50.77Age (years)56.25 (10.45)31.99 (13.17)0.001Disease duration (years)6.38 (6.15)5.61 (6.1)0.492ANAM total score-1.43 (0.85)-1.87 (0.96)0.008Simple reaction time25.554.50.001Simple reaction time score148.39 (32.44)144.13 (52.37)0.571Code substitution (Learning)13.79.10.411Code substitution (Learning) score33.39 (8.42)38.61 (14.23)0.001Procedural reaction time-Attention15.727.30.125Procedural reaction time-Attention score70.29 (12.11)73.17 (17.68)0.277Mathematical processing11.8130.838Mathematical processing score17.92 (11.07)15.57 (6.63)0.177Matching to sample-spatial work memory21.67.80.025Matching to sample-spatial work memory score20.08 (7.66)22.26 (8.72)0.139Code substitution-delayed memory15.77.80.161Code substitution-delayed memory score26 (11.57)33.69 (18.99)0.005Simple reaction time21.632.90.165Simple reaction time score148.88 (24.82)166.29 (38.87)0.004Go/No-Go, Inhibition21.65.20.005Go/No-Go, Inhibition score3.41 (1.573.27 (1.68)0.635Conclusion:Cognitive impairment was common in both diseases but the cognitive domains affected were different. Rheumatologists should be aware of these differences when evaluating cognitive dysfunction in SLE and pSS patients.References:[1]Kurtuluş F, Çay H, Parlak E, Yaman A. Montreal cognitive assessment in primary sjogren’s syndrome. A brief screening tool. Neurosciences. 2019;24(3):199-206.[2]Tayer-Shifman O, Green R, Beaton D, Ruttan L, Wither J, Tartaglia M et al. Validity evidence supports the use of automated neuropsychological assessment metrics as a screening tool for cognitive impairment in lupus. Arthritis Care & Research. 2019;.Disclosure of Interests:None declared