Anti–N‐methyl‐D‐aspartate receptor antibodies, cognitive dysfunction, and depression in systemic lupus erythematosus

Abstract

Range Achievement Test-3 (WRAT-3). Serum anti-NR2antibodies were measured by enzyme-linked immunosorbent assay using a pentapeptide from the human NMDA receptor.Results. Cognitive dysfunction was found in 28 of 60 patients (mild in 8, moderate in 20) before adjustment for WRAT-3 and in 35 of 60 patients (mild in 15, moderate in 11, and severe in 9) after adjustment for WRAT-3. The changes were most pronounced in the memory and visuospatial domains. There was no significant association between anti-NR2 antibody levels and cognition. On 1 H-MRSI, patients with moderate or severe cognitive dysfunction had significantly higher choline:creatine ratios in the dorsolateral prefrontal cortex and the white matter, compared with patients with mild or absent cognitive dysfunction. Anti-NR2 antibodies were significantly correlated with BDI scores; patients with BDI-II scores of >14 had higher serum levels of anti-NR2 antibodies (P ‫؍‬ 0.005, 95% confidence interval 0.83, 4.31), and there was a trend toward higher anti-NR2 antibody levels among patients who fulfilled the DSM-IV criteria for major depression.Conclusion. Serum anti-NR2 antibodies are associated with depressive mood but not with cognitive dysfunction in SLE at a given time point. Larger longitudinal studies are needed to address the possible association between anti-NR2 antibodies and depression in SLE.Cognitive dysfunction and depression are common manifestations of neuropsychiatric systemic lupus erythematosus (SLE) (1,2), with the reported prevalence of cognitive dysfunction ranging from 20% to 80% in

Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis: Results from an international inception cohort study

“…Omdal et al (19) reported an association between anti-NR2 antibodies and depressed mood as well as decreased short-term memory and learning. However, although there has been 1 additional report of an association with depression (44), 4 cross-sectional studies (20,(44)(45)(46) did not confirm these findings. In animal models, enhanced permeability of the bloodbrain barrier was a critical factor for anti-NR2 antibodies to enter the intrathecal space and gain access to neuronal cells (15).…”

Late Consequences of Chronic Pediatric Illness

“…Anti-Nmethyl-D-aspartate receptor antibodies have been associated with neuropsychiatric symptoms in SLE, but their presence alone does not explain cognitive dysfunction, depression, or anxiety in patients with SLE [76]. Anti-NR2a antibodies may be associated with depressed mood but may not be associated with cognitive dysfunction in patients with SLE [77]. Anti-neuronal antibodies and abnormalities seen on SPECT scan appear to be useful in diagnosing CNS-SLE in pediatric patients [68].…”

Autoantibodies involved in neuropsychiatric manifestations associated with systemic lupus erythematosus: a systematic review

“…Three further publications [57][58][59] were obtained from review of the reference lists of included articles.…”

“…Three further publications were obtained from review of the reference lists of included articles [57][58][59] . While one of those 59 showed and association between serum anti-NR2…”