Introduction: Neuropsychiatric involvement in systemic lupus erythematosus (NPSLE) includes a heterogeneous variety of neurological and psychiatric syndromes involving central, peripheral and autonomic nervous system. Neuropsychiatric lupus is associated with increased morbidity and mortality, and NPSLE has been proven to have
a profound effect on health-related quality-of-life. Cognitive impairment is one of the most common manifestations of NPSLE. The aim of our study was to assess cognitive dysfunction and its association with an inflammatory and non-inflammatory mechanism in a cohort of NPSLE patients. Methods: One-hundred patients with the diagnosis of systemic lupus erythematosus (SLE) were enrolled in our study. All patients underwent clinical neuro-psychological and psychiatric examinations and based on the results the diagnosis of cognitive dysfunction was established according to the ACR classification of NPSLE. In the study,
the presence of serum autoantibodies and promising molecule tumour necrosis factor-like weak inducer of apoptosis (TWEAK), which supposed to be involved in the pathogenesis of NPSLE, were evaluated.
Results: Cognitive dysfunction (a moderate to severe degree of a cognitive deficit) was found in fifty-seven percent of SLE patients. Of the examined biomarkers including TWEAK, none showed a significant association with cognitive impairment. The only antibodies associated with cognitive dysfunction were antiphospholipid antibodies. The antiphospholipid antibodies were two times higher in a group with cognitive dysfunction than in the group without cognitive impairment and the prevalence of the antiphospholipid syndrome was significantly higher in NPSLE patients (28.1% vs. 20.9%; p<0.05). Conclusion: Cognitive dysfunction significantly decreased the mental performance of patients with SLE. The presence of antiphospholipid antibodies indicates that cognitive dysfunction is probably associated with non-inflammatory mechanism rather than inflammation. Supported by MHCR 023728.
References:
1. Moravcova R, Posmurova M et al. Cognitive dysfunction in the Czech population of patients with systemic lupus erythematosus.
CesRevmtol:2010;18;2;85–91.
2. Fragoso-Loyo H, Atisha-Fregoso Y et al. Utility of TWEAK to assess neuropsychiatric disease activity in systemic lupus erythematosus.
Lupus:2016;25;364–36
