Cognitive dysfunction in systemic lupus erythematosus: Past, present, and future

Kozora, Elizabeth; Hanly, John G.; Lapteva, Larissa; Filley, Christopher M.

doi:10.1002/art.23991

Cited by 83 publications

(92 citation statements)

References 167 publications

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“…However, axonal loss and demyelination may also result from direct antibody attack on neuronal cells, either on neuronal bodies or in the WM tracts. 2 Although SLE and MS have notable differences in etiology, there is a marked overlap concerning the CNS inflammatory and neurodegenerative nature of these 2 diseases. 3 In 1972, Fulford et al 4 first coined the term "lupoid sclerosis" when referring to patients with SLE who presented with symptoms similar to those in MS. Additionally, neuropsychological and cognitive testing revealed similarities in cognitive profiles of patients with MS and those with SLE that may be the result of similar dysfunctional CNS structures.…”

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confidence: 99%

“…7,8 It is possible that these cognitive disturbances may be attributed to decreased WM integrity, the presence and extent of WM lesions, or GM damage, all of which are present in patients with MS and those with SLE. 2,3,[8][9][10] Unlike in MS, the relationship between cerebral pathology and resulting neuropsychiatric disorders in SLE is not well-established. Neuropsychiatric symptoms range from transient to chronic and are heterogeneous among patients.…”

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confidence: 99%

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Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Cesar

Dwyer

Shucard³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Multiple sclerosis and neuropsychiatric systemic lupus erythematosus are autoimmune diseases with similar CNS inflammatory and neurodegenerative characteristics. Our aim was to investigate white matter tract changes and their association with cognitive function in patients with MS and those with neuropsychiatric systemic lupus erythematosus compared with healthy controls by using diffusion tensor imaging.

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confidence: 99%

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confidence: 99%

Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Cesar

Dwyer

Shucard³

et al. 2015

AJNR Am J Neuroradiol

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“…Cerebral atrophy, white matter lesions and cerebral infarction have been correlated with the severity of CD 8 ( Figure 1). An apparently normal MRI in CD may be associated with microstructural and metabolic changes in white matter tissue suggesting potentially immune-mediated myelinopathy, which is best seen by spectroscopy and other advanced MRI techniques 19 . The pathophysiology of CD remains to be fully understood and may involve vascular abnormalities, intrathecal inflammatory cytokines and BBB disruption.…”

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confidence: 99%

“…The treatment for CD remains uncertain. Identification and management of secondary or exacerbating causes of CD is recommended 19 . Patients may respond to methylphenidate or prednisone (0.5 mg/kg) 19 .…”

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confidence: 99%

“…Identification and management of secondary or exacerbating causes of CD is recommended 19 . Patients may respond to methylphenidate or prednisone (0.5 mg/kg) 19 . Aspirin is only indicated for patients with cardiovascular comorbidities to improve cognitive performance; and memantine, an NMDA-receptor antagonist, prevents cognitive impairment from anti-NR2 antibodies in the murine model, but it has not been effective in SLE patients 23 .…”

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Neuropsychiatric Lupus in clinical practice

Alessi

Dutra

Neto

et al. 2016

Arq. Neuro-Psiquiatr.

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs, characterized by the production of autoantibodies and the development of tissue injury. The etiology of SLE is partially known, involving multiple genetic and environmental factors. As many as 50% of patients with SLE have neurological involvement during the course of their disease. Neurological manifestations are associated with impaired quality of life, and high morbidity and mortality rates. Nineteen neuropsychiatric syndromes have been identified associated with SLE, and can be divided into central and peripheral manifestations. This article reviews major neuropsychiatric manifestations in patients with SLE and discusses their clinical features, radiological findings and treatment options.

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Neurocognitive impairment in childhood‐onset systemic lupus erythematosus: Measurement issues in diagnosis

Williams¹,

Aranow²,

Ross³

et al. 2011

Arthritis Care & Research

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Objectives To assess the prevalence of neurocognitive impairment (NCI) in childhood-onset systemic lupus erythematosus (cSLE) comparing published classification criteria, and to examine associations between NCI, disease characteristics, psychosocial-well being and intelligence. Methods cSLE patients and ethnicity- and age-matched healthy controls completed a neuropsychological research battery, and results were categorized by three different NCI classification criteria with different cutoff scores (e.g., >2, 1.5, or 1 SD below mean) and number of required abnormal tests or domains. Results Forty-one cSLE subjects and 22 controls were included. Subjects were predominantly female (70%) and Hispanic (70%). Executive functioning, psychomotor and fine-motor speed were most commonly affected. Method 1 classified 34.1% of cSLE subjects with NCI, compared to Method 2 (14.6% with decline and 7.3 % with NCI) and Method 3 (63.4% with NCI). Prevalence of NCI was not significantly different between controls and patients using any of the categorization methods. NCI was not associated with SLE disease activity or characteristics, or with depression. Using Method 3, patients in the cognitive impairment group reported significantly lower quality of life estimates (69.7 vs 79.3, p=0.03). Below average intellectual functioning (IQ < 90) differentiated the number of test scores >1 and >1.5 SD, but not >2 SD below the mean. Conclusions NCI was prevalent in cSLE, but varied according to chosen categorization method. A similar proportion of cSLE patients and controls had NCI, reinforcing the importance of studying an appropriate control group. Categorical classification (i.e. impaired/nonimpaired) may oversimplify the commonly observed deficits in cSLE.

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Cognitive dysfunction in systemic lupus erythematosus: Past, present, and future

Cited by 83 publications

References 167 publications

Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Cognitive and White Matter Tract Differences in MS and Diffuse Neuropsychiatric Systemic Lupus Erythematosus

Neuropsychiatric Lupus in clinical practice

Neurocognitive impairment in childhood‐onset systemic lupus erythematosus: Measurement issues in diagnosis

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