Site differences in mild cognitive dysfunction (MCD) among patients with systemic lupus erythematosus (SLE)

Kozora, Elizabeth; Erkan, Doruk; West, SG; Filley, C M; Zhang, L; Ramon, G; Duggan, Emily C.; Lockshin,

doi:10.1177/0961203312468963

Cited by 15 publications

(16 citation statements)

References 30 publications

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“…ITG plays an important role in the processing of visual stimulus and is also involved in language fluency [36, 40–42]. Interestingly, previous studies showed patients with SLE frequently had cognitive dysfunction such as abnormal semantic fluency which resulted in negative impingement on social function [43–46]. In the present study, we performed MMSE that includes orientation, memory, attention, language fluency, apraxia, and alexia [47, 48].…”

Section: Discussionmentioning

confidence: 99%

Altered Amplitude of Low-Frequency Fluctuations in Inactive Patients with Nonneuropsychiatric Systemic Lupus Erythematosus

Chen

Wang

et al. 2019

Neural Plasticity

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ObjectiveThis study is aimed at investigating the characteristics of the spontaneous brain activity in inactive patients with nonneuropsychiatric systemic lupus erythematosus (non-NPSLE). Methods Thirty-one female inactive patients with non-NPSLE and twenty healthy controls were examined by resting-state functional magnetic resonance imaging (RS-fMRI). Three amplitude methods including amplitude of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and percent amplitude of fluctuation (PerAF) (with and without standardization) were applied to evaluate the spontaneous brain activity. The correlation was performed between low-frequency oscillations and clinical and neuropsychological factors in inactive patients with non-NPSLE. Results Compared to healthy controls, patients with non-NPSLE showed increased standardized ALFF (mALFF) in the left inferior temporal gyrus and left putamen, decreased PerAF in the right postcentral gyrus and bilateral precentral gyrus, and increased standardized PerAF (mPerAF) in the left putamen and decreased mPerAF in the right postcentral gyrus and bilateral precentral gyrus. By standardized fALFF (mfALFF), no significant brain regions were found between the two groups. Correlation analysis revealed significantly positive correlations between glucocorticoid dose and PerAF in the right precentral gyrus and mPerAF in the left putamen, and Complement 3 (C3) and mPerAF in the right postcentral gyrus. There was a significant negative correlation between C3 and mALFF in the left putamen. Conclusion Abnormal low-frequency oscillations in multiple brain regions were found in inactive patients with non-NPSLE, indicating that the alteration of mALFF, PerAF, and mPerAF in specific brain regions might be an imaging biomarker of brain dysfunction in inactive patients with non-NPSLE.

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Section: Discussionmentioning

confidence: 99%

Altered Amplitude of Low-Frequency Fluctuations in Inactive Patients with Nonneuropsychiatric Systemic Lupus Erythematosus

Chen

Wang

et al. 2019

Neural Plasticity

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“…The CNS-VS composite memory, including verbal memory, and visual memory, executive functioning, information processing speed, psychomotor speed, reaction time, complex attention and cognitive flexibility [ 38 , 40 ]. The test hence captures the cognitive dysfunctions common in SLE patients; such as dysfunction in complex attention, executive skills and psychomotor speed [ 43 , 44 ]. The CNS VS also measures reaction time/information processing speed, functions found to be of significance as concerns cognitive deficits in SLE patients [ 43 , 44 ].…”

Section: Methodsmentioning

confidence: 99%

“…The test hence captures the cognitive dysfunctions common in SLE patients; such as dysfunction in complex attention, executive skills and psychomotor speed [ 43 , 44 ]. The CNS VS also measures reaction time/information processing speed, functions found to be of significance as concerns cognitive deficits in SLE patients [ 43 , 44 ].…”

Section: Methodsmentioning

confidence: 99%

Altered white matter microstructure in lupus patients: a diffusion tensor imaging study

et al. 2018

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BackgroundThe purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms.MethodsStructural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2–52.2 years) and 21 healthy controls (mean age 36.7 years, range 23.3–51.2 years) in conjunction with clinical examination, laboratory tests, cognitive evaluation, and self-assessment questionnaires. The patients were subgrouped according to the American College of Rheumatology Neuropsychiatric Systemic Lupus Erythematosus case definitions into non-neuropsychiatric SLE (nonNPSLE) and neuropsychiatric SLE (NPSLE).ResultsComparisons between the SLE group and healthy controls showed that the mean fractional anisotropy (FA) was significantly reduced in the right rostral cingulum (p = 0.038), the mid-sagittal corpus callosum (CC) (p = 0.050), and the forceps minor of the CC (p = 0.015). The mean diffusivity (MD) was significantly increased in the left hippocampal cingulum (p = 0.017). No significant differences in MD or FA values were identified between NPSLE and nonNPSLE patients. Disease duration among all SLE patients correlated significantly with reduced FA in the CC (p < 0.05). No correlations were found between DTI parameters and white matter hyperintensities, SLE Disease Activity Index-2000, Systemic Lupus International Collaborating Clinical/ACR Organ Damage Index, or Montgomery Asberg Depression Rate Score Self-report.ConclusionsWe found alterations of white matter microstructure in SLE patients that were related to disease duration and fatigue. Our results indicate that cerebral involvement in SLE is not isolated to the NPSLE subgroup.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1516-0) contains supplementary material, which is available to authorized users.

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“…These studies have improved the understanding of SLE and highlighted cognitive decline as a potentially early observable, preceding more severe and clearly visible degradation of the central nervous system. However, several studies have indicated that cognitive dysfunction in SLE is not strongly coupled to markers of disease activity (Ho et al, 2016;Kozora, Arciniegas, et al, 2013;Kozora, Erkan, et al, 2013) and it has been proposed that cognitive decline has no predictive value for the development of other overt neuropsychiatric symptoms (Bertsias & Boumpas, 2010;Denburg, Carbotte, & Denburg, 1997).…”

mentioning

confidence: 99%

Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

Nystedt

Mannfolk

Jönsen

et al. 2019

J of Comparative Neurology

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To investigate core resting state networks in SLE patients with and without neuropsychiatric symptoms by examining functional connectivity changes correlating with results of cognitive testing. Structural MRI and resting state‐fMRI (rs‐fMRI) were performed in 61 female SLE patients (mean age: 36.8 years, range 18.2–52.0 years) and 20 healthy controls (HC) (mean age 36.2 years, range 23.3–52.2 years) in conjunction with clinical examination and cognitive testing. Alterations in core resting state networks, not found in our healthy controls sample, correlated with cognitive performance gauged by neuropsychological tests in non‐neuropsychiatric SLE (nNP) as well as in neuropsychiatric SLE patients (NP). The observed pattern of increased functional connectivity in core resting state networks correlated with reduced cognitive performance on all cognitive domains tested and with a heavy focus on DM, CE, and DM–CE in the NP subgroup. Furthermore, we found that the observed alterations in memory and psychomotor speed correlated with disease duration. In SLE patients both with and without clinically overt neuropsychiatric manifestations, we found changes in the functional connectivity of core resting state networks essential to cognitive functions. These findings may represent a rewiring of functional architecture in response to neuronal damage and could indicate suboptimal compensatory mechanisms at play.

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Site differences in mild cognitive dysfunction (MCD) among patients with systemic lupus erythematosus (SLE)

Cited by 15 publications

References 30 publications

Altered Amplitude of Low-Frequency Fluctuations in Inactive Patients with Nonneuropsychiatric Systemic Lupus Erythematosus

Altered Amplitude of Low-Frequency Fluctuations in Inactive Patients with Nonneuropsychiatric Systemic Lupus Erythematosus

Altered white matter microstructure in lupus patients: a diffusion tensor imaging study

Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

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