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Cognitive impairment observed in aPL-negative SLE, aPL-positive non-SLE patients
Patients with antiphospholipid antibody-negative systemic lupus erythematosus and antiphospholipid antibody-positive patients without systemic lupus erythematosus displayed cognitive dysfunction, according to recent study data.
Researchers conducted a cohort study of 20 antiphospholipid antibody (aPL)-negative systemic lupus erythematosus (SLE) and 20 aPL-positive non-SLE patients without a history of overt neuropsychiatric (NP) manifestations. The patients, all women, were drawn from the Hospital for Special Surgery rheumatology clinic and private practices in New York between October 2008 and December 2011. Mean disease duration for SLE patients was 153.8 ± 118.7 months, compared with 58.8 ± 80.1 months for aPL patients.
Patients took standardized cognitive tests for learning and memory; attention and working memory; executive functions; verbal fluency; visuoconstruction; and motor function. They also underwent cranial MRI to test their cognitive function. According to the results, 60% of SLE patients and 40% of APL-positive patients showed global cognitive impairment on a cognitive impairment index (CII). Differences on individual measures or CII were not significant.
Fifty percent of SLE patients with abnormal MRIs (n=10) and 80% with normal MRIs (n=10) were cognitively impaired (CII>4). In aPL patients, 45.5% with abnormal MRIs (n=11) were cognitively impaired compared with 33.3% with normal MRIs (n=9). No clinical, serologic or radiologic characteristics were associated with cognitive impairment, according to the study.
“This study demonstrates that aPL-negative SLE patients and aPL patients without SLE who have no history of overt/major NP disorder have high levels of global cognitive impairment,” researchers said. “Continued studies that assess and compare biobehavioral characteristics of patients with SLE, aPL and SLE with aPL who experience cognitive decline over time may be the next useful step in understanding and subsequently treating cognitive dysfunction.”
Disclosure: The researchers report no relevant financial disclosures.