The relationship of antiphospholipid antibodies to cognitive function in patients with systemic lupus erythematosus

Abstract

Objective: To examine the relationship between antiphospholipid antibody positivity (expressed as the lupus anticoagulant) and cognitive dysfunction in patients with systemic lupus erythematosus (SLE). Methods: Cross-sectional comparisons of lupus anticoagulant (LA) positive (N = 39) and negative (N = 79) patients and controls (N = 35) on a cognitive test battery; 22 LA-positive and 53 LA-negative patients who had never experienced neuropsychiatric events (never-NP–SLE) were also compared separately. Results: LA-positive patients were 2 to 3 times more likely than were LA-negative patients to be designated as cognitively impaired. As a group, LA-positive patients, particularly those in the never-NP–SLE group, demonstrated lower performance primarily on tasks of verbal memory, cognitive flexibility, and psychomotor speed. Conclusions: LA positivity is associated with subclinical nervous system compromise, and a pattern of deficits compatible with subcortical involvement, possibly on the basis of ongoing LA-related microthrombotic events or vasculopathy. (JINS, 1997, 3, 377–386.)

Neuropsychological dysfunction in systemic lupus erythematosus is not associated with changes in cerebral blood flow

“…Some studies [47,50,51] have proposed a relationship between aCL, LAC and cognitive dysfunction, while another study found no such association [52]. We found no associations between LAC or aCL and cognitive or SPECT abnormalities.…”

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

“…Although disease activity has been linked to neurocognitive outcomes in SLE, 36–40 we did not observe any association between disease duration, age at diagnosis, disease-related damage, or potential risk factors including antiphospholipid antibodies or renal disease and NCI as assessed by any of the three methods, although our small sample size may have limited our power to detect these associations. Poorer quality of life was associated with the more inclusive neurocognitive impairment defined in Method 3 and suggests the potential importance of employing greater leniency in our definitions of impairment, as well as accounting for the interrelations between mood and cognitive issues prevalent in this population.…”

Impaired memory and learning abilities in patients with systemic lupus erythematosus as measured by the Rey Auditory Verbal Learning Test

“…Cognitive impairment has been associated with various autoantibodies including antineuronal and lymphocytotoxic antibodies,35 36 antiribosomal P antibodies,37 – 39 the persistant presence of aPLs40 – 43 and possibly anti-NR2 antibodies,44 45 as well as increased levels of serum matrix metalloproteinase 9 (MMP-9), suggesting an association with small vessel cerebral ischaemic events 46…”