title: Neuropsychiatric syndromes in lupus: prevalence using standardized definitions.
abstract: OBJECTIVE
  The San Antonio Lupus Study of Neuropsychiatric Disease is a longitudinal study designed to characterize the spectrum of and important risk factors for specific neuropsychiatric systemic lupus erythematosus (NPSLE) syndromes.
  
  
  METHODS
  Subjects must meet criteria for SLE and must be at least 18 years of age. A standardized medical history, neurologic, rheumatologic, and psychiatric examinations, computerized neuropsychological evaluation, and serologic testing are performed.
  
  
  RESULTS
  This report is based on the first 128 subjects (120 women and 8 men) who completed the initial study visit. Data from this initial study visit were evaluated for the prevalence of NPSLE using the American College of Rheumatology case definitions for 19 NPSLE syndromes. One or more NPSLE syndromes were present in 80% of subjects: cerebrovascular disease (2, 2%; ischemic stroke); headaches (73, 57%); mononeuropathy (9, 8%; median 8, ulnar 1); movement disorder (1, 1%; chorea); neuropathy, cranial (2, 2%; trigeminal); polyneuropathy (29, 22%; sensorimotor); seizures (21, 16%; partial); anxiety disorder (27, 24%); major depressive-like episode (37, 28%); mood disorder with depressive features (21, 19%); mood disorder with manic features (3, 3%); mood disorder with mixed features (1, 1%); psychosis (6, 5%). In a subset of 67 patients who received standardized neuropsychological testing, 21% had normal results. In the remainder, the following levels of impairment were seen: 43% mild, 30% moderate, and 6% severe.
  
  
  CONCLUSIONS
  The prevalence of NPSLE was high in this cohort of unselected patients with SLE. Headaches, cognitive dysfunction, and psychiatric disorders were the most common NPSLE syndromes seen. These results will be easily comparable to other studies also using standardized diagnostic criteria. However, the lack of ethnicity and language-matched normative neuropsychological data may make comparisons of cognitive dysfunction in SLE populations difficult.
authors.affiliation: Department of Medicine, Division of Neurology, San Antonio, TX 78229-3900, USA. brey@uthscsa.edu
authors.forename: R L
authors.initials: RL
authors.lastname: Brey
authors.forename: S L
authors.initials: SL
authors.lastname: Holliday
authors.forename: A R
authors.initials: AR
authors.lastname: Saklad
authors.forename: M G
authors.initials: MG
authors.lastname: Navarrete
authors.forename: D
authors.initials: D
authors.lastname: Hermosillo-Romo
authors.forename: C L
authors.initials: CL
authors.lastname: Stallworth
authors.forename: C R
authors.initials: CR
authors.lastname: Valdez
authors.forename: A
authors.initials: A
authors.lastname: Escalante
authors.forename: I
authors.initials: I
authors.lastname: del Rincón
authors.forename: G
authors.initials: G
authors.lastname: Gronseth
authors.forename: C B
authors.initials: CB
authors.lastname: Rhine
authors.forename: P
authors.initials: P
authors.lastname: Padilla
authors.forename: D
authors.initials: D
authors.lastname: McGlasson
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000523:psychology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology