title: Memory dysfunction in primary Sjögren's syndrome is associated with anti-NR2 antibodies.
abstract: OBJECTIVE
  Our understanding of the etiology and pathogenesis of neuropsychiatric involvement in primary Sjögren's syndrome (SS) is incomplete. In systemic lupus erythematosus, it has been reported that antibodies directed against N-methyl-D-aspartate receptor subtype NR2 (anti-NR2) interfere with memory and learning function, as well as mood. This has not been investigated in primary SS; however, the present study was undertaken to advance our understanding of neuropsychiatric involvement in this disease.
  
  
  METHODS
  Sixty-six patients with primary SS and 66 age- and sex-matched healthy control subjects underwent clinical examination and neuropsychological evaluation. Anti-NR2 antibodies were measured in serum and cerebrospinal fluid. Hippocampus volume was estimated using software extensions to SPM5.
  
  
  RESULTS
  Patients with primary SS had smaller hippocampi than healthy subjects (mean ± SD 8.15 ± 0.98 cm(3) versus 8.49 ± 0.88 cm(3); P = 0.01). In patients with primary SS, anti-NR2 antibodies in cerebrospinal fluid were associated with a worse performance in 8 of 10 memory and learning tests, and anti-NR2 antibodies in serum were associated with a worse performance in 6 of those same tests. In addition, a higher proportion of patients with depression than patients without depression had serum anti-NR2 antibody levels above the cutoff value.
  
  
  CONCLUSIONS
  Results of this study indicate that anti-NR2 antibodies may represent one of the pathogenetic mechanisms for cognitive disturbances and mood disorders in patients with primary SS.
authors: Stavanger University Hospital, Stavanger, Norway.
authors: Maria B
authors: MB
authors: Lauvsnes
authors: Stian S
authors: SS
authors: Maroni
authors: Simone
authors: S
authors: Appenzeller
authors: Mona K
authors: MK
authors: Beyer
authors: Ole J
authors: OJ
authors: Greve
authors: Jan T
authors: JT
authors: Kvaløy
authors: Erna
authors: E
authors: Harboe
authors: Lasse G
authors: LG
authors: Gøransson
authors: Anne B
authors: AB
authors: Tjensvoll
authors: Roald
authors: R
authors: Omdal
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000276:immunology* / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000150:complications / Q000276:immunology* / Q000523:psychology
chemical_list: D001323:Autoantibodies; C120997:NR2A NMDA receptor; D016194:Receptors, N-Methyl-D-Aspartate