title: Factors and comorbidities associated with first neuropsychiatric event in systemic lupus erythematosus: does a risk profile exist? A large multicentre retrospective cross-sectional study on 959 Italian patients.
abstract: OBJECTIVE
  To analyse risk factors and comorbidities potentially associated with CNS involvement in a large cohort of Italian patients affected by SLE.
  
  
  METHODS
  A number of generic (not strictly SLE related) and specific (disease related) risk factors to which all patients have been exposed in the span of 5 years before the first neuropsychiatric (NP) event or before the last available observation were checked for and their distribution was analysed in 959 SLE patients with and without NP involvement; all the first NP events that occurred in a time frame of 10 years were recorded and categorized as SLE related or SLE unrelated.
  
  
  RESULTS
  Three hundred and twenty-six SLE patients with and 633 SLE patients without NP manifestations were included in the study. A total of 469 NP events were recorded. Headache (26.1%), cerebrovascular events (22.7%), mood disorders (8.9%), seizures (14.4%) and cognitive dysfunctions (9.5%) were the most frequent SLE-related NP events. More risk factors [mean 4.52 (2.44) vs 3.73 (2.01); P < 0.0001] were observed in patients with than without NP involvement. Overall, aPLs, LA and APS were factors more strongly associated with NP involvement.
  
  
  CONCLUSIONS
  In SLE, NP involvement and aPLs were confirmed as closely related. Furthermore, other modifiable generic risk factors, such as hypertension, carotid vasculopathy and dyslipidaemia, appeared to be related to the occurrence of cerebral vascular accident (CVA) and cognitive dysfunctions, suggesting the need for a more intensive preventive strategy to optimize the management of NP lupus.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Rheumatology, University of Ferrara, C.so Giovecca 203, 44121 Ferrara, Italy. gvl@unife.it
authors.forename: Marcello
authors.initials: M
authors.lastname: Govoni
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bortoluzzi
authors.forename: Luisa
authors.initials: L
authors.lastname: Caniatti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Casu
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Conti
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Vita
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Ilaria
authors.initials: I
authors.lastname: Farina
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferraccioli
authors.forename: Elisa
authors.initials: E
authors.lastname: Gremese
authors.forename: Elisa
authors.initials: E
authors.lastname: Mansutti
authors.forename: Marta
authors.initials: M
authors.lastname: Mosca
authors.forename: Melissa
authors.initials: M
authors.lastname: Padovan
authors.forename: Matteo
authors.initials: M
authors.lastname: Piga
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Tola
authors.forename: Paola
authors.initials: P
authors.lastname: Tomietto
authors.forename: Marco
authors.initials: M
authors.lastname: Taglietti
authors.forename: Francesco
authors.initials: F
authors.lastname: Trotta
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
authors.forename: Margherita
authors.initials: M
authors.lastname: Zen
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000453:epidemiology / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D004812:Epidemiologic Methods; D005260:Female; D020773:Headache Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000453:epidemiology / Q000209:etiology
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers