title: Systemic lupus erythematosus patients with past neuropsychiatric involvement are associated with worse cognitive impairment: a longitudinal study.
abstract: Longitudinal studies on cognitive impairment in patients with past history of neuropsychiatric lupus (NPSLE) are scant. In this study, NPSLE patients and matched disease and healthy controls were examined with a full battery of neuropsychological tests that covered eight cognitive domains at two time-points 12 months apart. Confounders, including depressive and anxiety symptoms, were measured by the Hospital Anxiety and Depression Scale. Eighteen NPSLE, 18 patients with systemic lupus erythematosus (SLE) who had no previous cerebral involvement (non-NPSLE) and 16 healthy subjects were recruited. NPSLE patients consistently reported more cognitive and anxiety symptoms than non-NPSLE patients over both time-points. NPSLE patients had significantly worse memory, simple and complex attention compared to non-NPSLE patients, among which memory remained significantly impaired after adjustment for confounders. NPSLE patients demonstrated a trend of higher raw scores of some neurocognitive tests upon re-evaluation over 12 months, but NPSLE patients did not demonstrate any practice effect. In conclusion, NPSLE patients had significantly worse and persistently impaired memory and learning deficits compared to non-NPSLE patients over the 12-month re-assessment period.
authors.affiliation: Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: Y
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Psychology, University of Hong Kong, Hong Kong.
authors.forename: E Y Y
authors.initials: EY
authors.lastname: Lau
authors.affiliation: Department of Psychology, University of Hong Kong, Hong Kong.
authors.forename: J H Y
authors.initials: JH
authors.lastname: Wan
authors.affiliation: Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: C S
authors.initials: CS
authors.lastname: Lau
authors.affiliation: Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Hong Kong, Hong Kong temy@hkucc.hku.hk.
authors.forename: M Y
authors.initials: MY
authors.lastname: Mok
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales
keywords: Cognitive dysfunction; mood disorder; neuropsychiatric lupus; systemic lupus erythematosus