title: Cognitive dysfunction in antiphospholipid antibody (aPL)-negative systemic lupus erythematosus (SLE) versus aPL-positive non-SLE patients.
abstract: OBJECTIVE
  The aim of this study was to compare the cognitive function of antiphospholipid antibody (aPL)-negative systemic lupus erythematosus (SLE) and aPL-positive non-SLE patients.
  
  
  METHODS
  Twenty aPL-negative SLE and 20 aPL-positive non-SLE female patients with no history of overt neuropsychiatric manifestations took standardised cognitive tests of learning and memory, attention and working memory, executive functions, verbal fluency, visuoconstruction, and motor function. The primary outcome measure was an established global cognitive impairment index (CII). Cranial magnetic resonance imaging (MRI) was also obtained on all patients.
  
  
  RESULTS
  Twelve of 20 (60%) of the SLE and 8/20 (40%) of the aPL-positive patients had global cognitive impairment on CII; there were no group differences on CII or on individual measures. Cognitive impairment was not associated with duration of disease, level of disease activity, or prednisone use. No correlations were found between clinical disease factors and cognitive impairment, and neither group showed an association between incidental or major MRI abnormalities and cognitive dysfunction.
  
  
  CONCLUSIONS
  Both aPL-negative SLE and aPL-positive non-SLE patients, without other overt neuropsychiatric disease, demonstrated high levels of cognitive impairment. No clinical, serologic, or radiologic characteristics were associated with cognitive impairment. Cognitive dysfunction is common in APS and in SLE, but its mechanisms remain unknown.
authors.affiliation: Department of Medicine, National Jewish Health, Denver, USA. kozorae@njhealth.org.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kozora
authors.forename: Doruk
authors.initials: D
authors.lastname: Erkan
authors.forename: Lening
authors.initials: L
authors.lastname: Zhang
authors.forename: Robert
authors.initials: R
authors.lastname: Zimmerman
authors.forename: Glendalee
authors.initials: G
authors.lastname: Ramon
authors.forename: Aziz M
authors.initials: AM
authors.lastname: Ulug
authors.forename: Michael D
authors.initials: MD
authors.lastname: Lockshin
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D001288:Attention; D015415:Biomarkers / Q000097:blood; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D007858:Learning; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008570:Memory, Short-Term; D008875:Middle Aged; D009048:Motor Skills; D009483:Neuropsychological Tests; D014705:Verbal Behavior
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers