title: Cognitive impairment in systemic lupus erythematosus women with elevated autoantibodies and normal single photon emission computerized tomography.
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) is known to induce psychiatric disorders, from psychoses to maladaptive coping. Brain autoantibodies were proposed to explain SLE neuropsychiatric disorders and found to be elevated before the onset of clinical symptoms. We assessed cognition in Caucasian SLE women with elevated autoantibodies without overt neuropsychiatric syndromes, in conjunction with single photon emission computerized tomography (SPECT).
  
  
  METHODS
  31 women meeting SLE criteria of the American College of Rheumatology (ACR) were included. Patients who met the ACR neuropsychiatric definition were excluded. Matched controls were 23 healthy women from the Champagne-Ardenne region, France. Participants completed neuropsychological and autoantibodies measurements, and 19 completed SPECT.
  
  
  RESULTS
  61% (19/31) of women with SLE and 53% (9/17) of those with normal SPECT had significant global cognitive impairment defined as 4 T-scores <40 in cognitive tests, compared to 0% (0/23) of controls. SLE women also had significantly greater cognitive dysfunction (mean T-score) on the Wechsler Adult Intelligence Scale (WAIS) visual backspan, Trail Making Test A and B, WAIS Digit Symbol Substitution Test and Stroop Interference, compared to controls. Elevated antinuclear antibody correlated with impairment in the WAIS visual span, WAIS visual backspan, and cancellation task; elevated anti-double-stranded DNA antibody and anticardiolipin correlated respectively with impairment in the Trail Making Test A and WAIS auditive backspan. Two SLE women had abnormal SPECT.
  
  
  CONCLUSIONS
  A high prevalence of cognitive deficits was found in Caucasian SLE women compared to normal women, which included impairment in cognitive domains important for daily activities. Elevated autoantibodies tended to correlate with cognitive dysfunction.
authors: Department of Psychiatry, Université Pierre et Marie Curie and Saint-Antoine Hospital, Paris, France. charles.peretti @ sat.aphp.fr
authors: Charles-Siegfried
authors: CS
authors: Peretti
authors: Charles Roger
authors: CR
authors: Peretti
authors: Elizabeth
authors: E
authors: Kozora
authors: Dimitri
authors: D
authors: Papathanassiou
authors: Virginie-Anne
authors: VA
authors: Chouinard
authors: Guy
authors: G
authors: Chouinard
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D015995:Prevalence; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D044465:White People
chemical_list: D001323:Autoantibodies