Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and structural brain changes

Barraclough, Michelle; McKie, Shane; Parker, Benjamin; Jackson, Alan; Pemberton, Phillip; Elliott, Richard M.; Bruce, Ian N.

doi:10.1136/annrheumdis-2018-214677

Cited by 58 publications

(45 citation statements)

References 41 publications

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“…In fact, there is evidence for the involvement of multiple aspects of the immune system in NPSLE, including neurotoxic autoantibodies, pro-inflammatory cytokines and cell-mediated effects, in conjunction with abnormalities in neuroimmune interfaces including the choroid plexus and blood-brain barrier which allow systemic autoimmune drivers into the central nervous system [21,24]. Specifically, several studies have pointed to increased systemic levels of cytokines such as interleukin 6 (IL-6) and neurotoxic anti-N-methyl-D-aspartate receptor (NMDAR) antibodies in SLE patients with CD [25][26][27]. In addition, type I interferon (IFN-I) and anti-NMDAR antibodies were shown to enhance microglia activation, leading to aberrant synaptic pruning with subsequent CD [28,29].…”

Section: Pathogenesismentioning

confidence: 99%

Cognitive dysfunction in autoimmune rheumatic diseases

Oláh¹,

Schwartz

Denton

et al. 2020

Arthritis Res Ther

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For people with chronic autoimmune rheumatic diseases (AIRD), such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or systemic sclerosis (SSc), normal cognitive functions are essential for performing daily activities. These diseases may be associated with cognitive dysfunction (CD). In RA, CD has been associated with age, lower education and disease duration and activity. Great advances have been achieved in neuropsychiatric SLE in the identification of pathogenic pathways, assessment and possible treatment strategies. SSc rarely exerts direct effects on the brain and cognitive function. However, the psychological burden that includes depression, anxiety and social impact may be high. AIRD patients with sustained disease activity, organ damage or lower education should be evaluated for CD. The control of systemic inflammation together with tailored behavioural cognitive therapies may benefit these patients.

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Section: Pathogenesismentioning

confidence: 99%

Cognitive dysfunction in autoimmune rheumatic diseases

Oláh¹,

Schwartz

Denton

et al. 2020

Arthritis Res Ther

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“…The cognitive function assessment form has been developed to define a series of standardized detection tools that can be used to determine the integrity of central nervous system function. 14 In recent decades, a large number of studies have been conducted on cognitive impairment in SLE using various cognitive scales, but the reported incidence rate of SLE-related cognitive impairment varies widely. 15 MMSE is a 30-point questionnaire that is used extensively in clinical research.…”

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow abnormalities in neuropsychiatric systemic lupus erythematosus

Jia

Xie

et al. 2019

Lupus

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Objective To investigate the clinical characteristics, imaging changes and early diagnostic methods of neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Thirty-five SLE patients, of which 16 had overt neuropsychiatric symptoms, underwent examination for multiple autoantibodies, including anti-double-stranded DNA (anti-dsDNA) antibody, anti-nucleosome antibody, anti-cardiac-phospholipid antibody (aCL)-IgG, aCL-IgM, anti-β2-glycoprotein I antibody and anti-ribosomal P antibody, and the SLEDAI score of every patient was recorded. All patients further received neuropsychological tests, including the Mini-Mental State Examination, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale. Imaging examination using 3D arterial spin labeling was performed on 3.0 T MRI scanners. After processing the 3D arterial spin labeling image, the cerebral blood flow map was obtained and the cerebral blood flow value was calculated. Results The values of anti-dsDNA, anti-nucleosome antibody, aCL-IgG and anti-β2-glycoprotein I antibodies were significantly higher in the NPSLE group than those in the SLE group. The SLEDAI scores of the NPSLE group were significantly higher than those of the SLE group. There were no significant differences between the NPSLE group and the SLE group in the directional ability, memory, attention, numeracy, recall ability or language ability scores on the Mini-Mental State Examination scale. Furthermore, there were no symptoms of anxiety or depression in any of the patients, according to the Self-Rating Anxiety Scale and Self-Rating Depression Scale. In the 35 patients with SLE, decreases in blood perfusion were seen in some areas, and were unilateral and asymmetrically distributed. There was obvious asymmetry between sides in areas including the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The incidence of perfusion decreases in frontal lobe in the NPSLE group was significantly higher than in the SLE group. Conclusion Neurological lesions in SLE patients can be detected by arterial spin labeling. Cerebral blood flow abnormalities may be helpful for the early diagnosis of neurological lesions in NPSLE.

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“…14 An innovative approach was put forward by Barraclough and colleagues, who combined a functional magnetic resonance (fMRI) approach with tests from the computerized Cambridge Neuropsychological Test Automated Battery (CANTAB) to examine brain responses to working memory tasks in patients with systemic lupus erythematosus. 15 The study identified a dissociated profile, with deficits in sustained attention, and compensatory brain activity to maintain similar levels of working memory performance when compared to healthy controls. An advantage of such computerized neuropsychological batteries is that they represent sensitive, standardized tools which offer both speed and accuracy indexes of performance.…”

Section: Introductionmentioning

confidence: 98%

“…Our target was a sample of patients with RA, tested with more sensitive measures from two computerized neuropsychological batteries, CANTAB 17 and Automated Working Memory Assessment (AWMA). 18 CANTAB tasks have shown sensitivity to cognitive dysfunction and have been widely used across different clinical groups, 15,[19][20][21] yet to our knowledge, they have not been administered to patients with RA. We aimed to provide a detailed computerized investigation of verbal and visuospatial short-term and working memory (dys)functions in RA patients, assessing both accuracy and response speed, while controlling for variables known to influence cognitive function in this condition (age, disease-related activity, affective problems, other clinical parameters).…”

Section: Introductionmentioning

confidence: 99%

<p>A Computerized Assessment of Verbal and Visuospatial Memory (Dys)functions in Patients with Rheumatoid Arthritis</p>

Petra

Visu‐Petra

Buta

et al. 2020

PRBM

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Purpose: Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease associated with various degrees of impairment across different cognitive domains. We aimed to provide a detailed computerized investigation of verbal and visuospatial short-term and working memory (dys)functions in RA patients, assessing both accuracy and response speed, while relating them to age, disease-related activity, affective problems, psychomotor speed and other clinical parameters. Patients and Methods: The study included 29 RA patients (mean age 50.6 ± 12.3 years, 79% female) and 30 controls (matched according to age, gender and education), assessed with short-term and working memory tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Automated Working Memory Assessment (AWMA). Results: RA patients were significantly slower on the basic processing speed test (Motor Screening Test, p =0.003). Their short-term information storage (verbal and visuospatial) was comparable to controls, yet this similar accuracy came at the expense of a longer response time to retain information correctly (on spatial span, p = 0.04). On tasks with higher executive demands, both visuospatial and verbal working memory were compromised, as RA patients took longer (p = 0.004) and had a higher number of total errors (p = 0.02) when conducting a strategic memoryguided search (Spatial Working Memory), and had a significantly lower verbal working memory span on the backwards digit recall test (p = 0.02). Conclusion: The findings of this study emphasize the usefulness of performing computerized tests to detect subtle signs of cognitive impairment and of intact performance, which can inform memory training protocols for this vulnerable population.

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Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and structural brain changes

Cited by 58 publications

References 41 publications

Cognitive dysfunction in autoimmune rheumatic diseases

Cognitive dysfunction in autoimmune rheumatic diseases

Cerebral blood flow abnormalities in neuropsychiatric systemic lupus erythematosus

<p>A Computerized Assessment of Verbal and Visuospatial Memory (Dys)functions in Patients with Rheumatoid Arthritis</p>

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