Memory impairment associated with neurometabolic abnormalities of the hippocampus in patients with non-neuropsychiatric systemic lupus erythematosus

Kozora, Elizabeth; Brown, Mark S.; Filley, Christopher M.; Zhang, L; Miller, David E.; West, SG; Pelzman, J; Arciniegas, David B.

doi:10.1177/0961203310392425

Cited by 35 publications

(78 citation statements)

References 49 publications

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“…This approach was taken to avoid the neuropsychological effects of the various neuropsychiatric syndromes. The number of patients in our study is also relatively small (n = 31) compared to 52 patients in the study of Kozora et al [10] in the same SLE population, and 81 patients in their neurometabolic study of the hippocampus and memory [11]. In addition, it should be noted that the two psychologists who did the testing were not blind to patient and control status.…”

Section: Discussionmentioning

confidence: 99%

“…Perfusion SPECT studies of SLE patients showed impairment in several brain regions: occipital, frontal, temporal, parietal cortices, and basal ganglia, with more frequent abnormalities in the parietal and temporal regions [39]. Recently, Kozora et al [11] reported a trend for reduced hippocampal volumes to be associated with memory impairment in non-neuropsychiatric SLE. Overall, previous brain imaging studies have shown a range of 10–17% of abnormal imaging in patients with non-neuropsychiatric SLE [39]; our finding of 11% (2/17/) of abnormal SPECT in SLE women is within this range.…”

Section: Discussionmentioning

confidence: 99%

“…Our results are in accordance with the majority of the SLE studies reviewed by Denburg and Denburg [2], who reported cognitive deficits in 3 or more of the following 5 domains: verbal learning/memory, visuospatial skills, psychomotor speed/manual dexterity, attention/mental flexibility and general intelligence, with two studies in all 5 domains. More recently, Kozora et al [11] showed significant memory impairment in non-neuropsychiatric SLE.…”

Section: Discussionmentioning

confidence: 99%

“…Our results would thus apply to this SLE population of Caucasian women. In addition, we selected SLE patients without overt neuropsychiatric syndromes as did Kozora et al [10] in their SLE study of coping styles, and more recently in their volumetric magnetic resonance imaging and magnetic resonance spectroscopy study of the right and left hippocampus [11]. This approach was taken to avoid the neuropsychological effects of the various neuropsychiatric syndromes.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, SLE has been closely associated with psychiatry from psychoses [6] to maladaptive coping styles [10]. In our study, we included non-neuropsychiatric SLE patients as did Kozora et al [10] in their study on coping styles and in their recent study in which they found that lower N-acetylaspartic acid/creatinine in the right hippocampus significantly related to memory impairment in non-neuropsychiatric SLE [11]. Cognitive behavioral therapy has been found to improve psychological disorder and quality of life in SLE patients with high levels of stress, even though the index of severity of SLE illness remained the same [12].…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Impairment in Systemic Lupus Erythematosus Women with Elevated Autoantibodies and Normal Single Photon Emission Computerized Tomography

Peretti

Peretti²,

Kozora³

et al. 2012

Psychother Psychosom

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Background: Systemic lupus erythematosus (SLE) is known to induce psychiatric disorders, from psychoses to maladaptive coping. Brain autoantibodies were proposed to explain SLE neuropsychiatric disorders and found to be elevated before the onset of clinical symptoms. We assessed cognition in Caucasian SLE women with elevated autoantibodies without overt neuropsychiatric syndromes, in conjunction with single photon emission computerized tomography (SPECT). Methods: 31 women meeting SLE criteria of the American College of Rheumatology (ACR) were included. Patients who met the ACR neuropsychiatric definition were excluded. Matched controls were 23 healthy women from the Champagne-Ardenne region, France. Participants completed neuropsychological and autoantibodies measurements, and 19 completed SPECT. Results: 61% (19/31) of women with SLE and 53% (9/17) of those with normal SPECT had significant global cognitive impairment defined as 4 T-scores <40 in cognitive tests, compared to 0% (0/23) of controls. SLE women also had significantly greater cognitive dysfunction (mean T-score) on the Wechsler Adult Intelligence Scale (WAIS) visual backspan, Trail Making Test A and B, WAIS Digit Symbol Substitution Test and Stroop Interference, compared to controls. Elevated antinuclear antibody correlated with impairment in the WAIS visual span, WAIS visual backspan, and cancellation task; elevated anti-double-stranded DNA antibody and anticardiolipin correlated respectively with impairment in the Trail Making Test A and WAIS auditive backspan. Two SLE women had abnormal SPECT. Conclusions: A high prevalence of cognitive deficits was found in Caucasian SLE women compared to normal women, which included impairment in cognitive domains important for daily activities. Elevated autoantibodies tended to correlate with cognitive dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cognitive Impairment in Systemic Lupus Erythematosus Women with Elevated Autoantibodies and Normal Single Photon Emission Computerized Tomography

Peretti

Peretti²,

Kozora³

et al. 2012

Psychother Psychosom

View full text Add to dashboard Cite

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Increased Risk of Dementia in Patients With Systemic Lupus Erythematosus: A Nationwide Population‐Based Cohort Study

Lin

Chou

Chen

et al. 2016

Arthritis Care & Research

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Memory Dysfunction in Primary Sjögren's Syndrome Is Associated With Anti‐NR2 Antibodies

Lauvsnes

Maroni

Appenzeller

et al. 2013

Arthritis & Rheumatism

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Objective. Our understanding of the etiology and pathogenesis of neuropsychiatric involvement in primary Sjögren's syndrome (SS) is incomplete. In systemic lupus erythematosus, it has been reported that antibodies directed against N-methyl-D-aspartate receptor subtype NR2 (anti-NR2) interfere with memory and learning function, as well as mood. This has not been investigated in primary SS; however, the present study was undertaken to advance our understanding of neuropsychiatric involvement in this disease.Methods. Sixty-six patients with primary SS and 66 age-and sex-matched healthy control subjects underwent clinical examination and neuropsychological evaluation. Anti-NR2 antibodies were measured in serum and cerebrospinal fluid. Hippocampus volume was estimated using software extensions to SPM5.Results. Patients with primary SS had smaller hippocampi than healthy subjects (mean ؎ SD 8.15 ؎ 0.98 cm 3 versus 8.49 ؎ 0.88 cm 3 ; P ‫؍‬ 0.01). In patients with primary SS, anti-NR2 antibodies in cerebrospinal fluid were associated with a worse performance in 8 of 10 memory and learning tests, and anti-NR2 antibodies in serum were associated with a worse performance in 6 of those same tests. In addition, a higher proportion of patients with depression than patients without depression had serum anti-NR2 antibody levels above the cutoff value.Conclusion. Results of this study indicate that anti-NR2 antibodies may represent one of the pathogenetic mechanisms for cognitive disturbances and mood disorders in patients with primary SS.

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Memory impairment associated with neurometabolic abnormalities of the hippocampus in patients with non-neuropsychiatric systemic lupus erythematosus

Cited by 35 publications

References 49 publications

Cognitive Impairment in Systemic Lupus Erythematosus Women with Elevated Autoantibodies and Normal Single Photon Emission Computerized Tomography

Cognitive Impairment in Systemic Lupus Erythematosus Women with Elevated Autoantibodies and Normal Single Photon Emission Computerized Tomography

Increased Risk of Dementia in Patients With Systemic Lupus Erythematosus: A Nationwide Population‐Based Cohort Study

Memory Dysfunction in Primary Sjögren's Syndrome Is Associated With Anti‐NR2 Antibodies

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