Systemic lupus erythematosus patients with past neuropsychiatric involvement are associated with worse cognitive impairment: a longitudinal study

Abstract

Longitudinal studies on cognitive impairment in patients with past history of neuropsychiatric lupus (NPSLE) are scant. In this study, NPSLE patients and matched disease and healthy controls were examined with a full battery of neuropsychological tests that covered eight cognitive domains at two time-points 12 months apart. Confounders, including depressive and anxiety symptoms, were measured by the Hospital Anxiety and Depression Scale. Eighteen NPSLE, 18 patients with systemic lupus erythematosus (SLE) who had no previous cerebral involvement (non-NPSLE) and 16 healthy subjects were recruited. NPSLE patients consistently reported more cognitive and anxiety symptoms than non-NPSLE patients over both time-points. NPSLE patients had significantly worse memory, simple and complex attention compared to non-NPSLE patients, among which memory remained significantly impaired after adjustment for confounders. NPSLE patients demonstrated a trend of higher raw scores of some neurocognitive tests upon re-evaluation over 12 months, but NPSLE patients did not demonstrate any practice effect. In conclusion, NPSLE patients had significantly worse and persistently impaired memory and learning deficits compared to non-NPSLE patients over the 12-month re-assessment period.

Cognitive dysfunction improves in systemic lupus erythematosus: Results of a 10 years prospective study

“…[ 22 – 25 ] Taken together, these studies suggested that CI is a relatively consistent and stable finding in SLE patients. [ 22 – 25 ] Nonetheless, longer follow-up may better depict the evolvement of this neuropsychiatric manifestation.…”

“…To sum up, in most of the studies a fluctuating or stable trend was identified more frequently than worsening. [ 22 – 25 ]…”

“…[ 22 ] According with these results, Gao and colleagues reported a worsening of cognitive ability after 12-month follow-up only in NPSLE patients, in comparison with non-NPSLE and healthy control. [ 25 ] Waterloo and colleagues investigated the changes of different neuro-psychological variables after 5years of follow-up in a 28-patients cohort. In particular, a stable pattern was identified in all variables but two (namely, Category test and Seashore Rhythm Test).…”

Longitudinal evaluation of diffusion tensor imaging and cognition in systemic lupus erythematosus

“…29–32 Prospective neuropsychological studies in SLE have either suggested persistent, emergent, and improved cognition at one to five year intervals, but many methodological issues limit the utility of these findings. 33–38 Finally, in a recent study of 18 NP SLE patients matched with 18 SLE patients without NP, 13 subjects from each group were re-evaluated after one year; 39 the non-NP SLE patients showed statistically significant improvement in attention and visuoconstruction whereas the NP SLE group showed no improvement.…”

Fatigue and cognitive impairment in immune thrombocytopenic purpura remain stable over time: short report from a longitudinal study

“…These results concur with other studies, for example, SS patients were found to have no significant cognitive decline over the course of 8 years (Martinez et al , ). Moreover, one study observing CI in systemic lupus erythematosus observed fluctuating, improving or stable trends more frequently than worsening CI over time (Gao et al , ). These disparities in findings suggest that the CFQ may not be sensitive to low levels of change in CI severity.…”