Corticosteroids and neuropsychological functioning in patients with systemic lupus erythematosus

Denburg, Susan D.; Carbotte, Ramona M.; Denburg, Judah A.

doi:10.1002/art.1780370907

Cited by 139 publications

(88 citation statements)

References 37 publications

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“…An association between steroid dose and low performance in attention tests was reported in unselected SLE [37], but no association was found using a global cognitive score in nSLE [15]. A study in healthy humans demonstrated a dysfunctional effect of prednisone on verbal learning [38], but cognitive improvement was reported after a brief exposure to prednisone in SLE women with mild neuropsychiatric symptoms [39]. In another study, no significant associations were found between antimalarials and cognition [37].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Dysfunction in Systemic Lupus Erythematosus: Prevalence and Correlates

Olazarán

López-Longo²,

Cruz

et al. 2009

Eur Neurol

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Little is known about the mechanisms and relevance of cognitive dysfunction in systemic lupus erythematosus (SLE) patients who never displayed major neuropsychiatric manifestations (nSLE). Thirty-one nSLE female patients and 31 cognitively healthy control women were recruited. Sociodemographic, clinical, neuropsychological and SLE-related markers were collected including cerebral perfusion by single-photon emission computed tomography. Prevalences of cognitive complaints were 22.6% in nSLE versus 6.5% in the control group (p = 0.147); respective prevalences of cognitive dysfunction were 32.3 versus 6.5% (p = 0.01). Within the nSLE group, all cognitive domains appeared similarly affected, and correlations were found between cognitive dysfunction and less skilled occupation (r = –0.41, p = 0.02) and between cognitive complaints and depressive symptoms (r = 0.35, p = 0.05). Cognitive dysfunction is rather frequent in nSLE and seems to negatively impinge on social functioning.

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Section: Discussionmentioning

confidence: 99%

Cognitive Dysfunction in Systemic Lupus Erythematosus: Prevalence and Correlates

Olazarán

López-Longo²,

Cruz

et al. 2009

Eur Neurol

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“…As noted above, most studies have found little association between steroid treatment and cognitive impairment in SLE (Ginsburg et al 1992;Glanz et al 1997b), although contradictory findings have been reported (Hanly et al 1992). There are some data to suggest that steroid treatment can improve cognitive performance (Denburg et al 1994). Altogether, these data suggest that cerebral pathology is the critical factor in the development of cognitive impairment in SLE, and that indirect effects related to the presence or severity of symptoms due to organ involvement or to factors such as depression and corticosteroid use are less important in the measurement of neuropsychological morbidity.…”

Section: Cognitive Disorder In Slementioning

confidence: 99%

Neuropsychological Impairment in Systemic Lupus Erythematosus: A Comparison with Multiple Sclerosis

et al. 2008

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In this manuscript, we review literature describing the neuropsychological and brain imaging characteristics of systemic lupus erythematosus (SLE) patients. The findings are compared and contrasted with multiple sclerosis (MS) studies, revealing similarities and differences of interest to clinicians and researchers. While cognitive impairment is somewhat less common in SLE than MS, the diseases share a similar cognitive profile with deficits most prominent on tests emphasizing the speed of information processing, working memory, and visual/spatial learning, and memory. In early or more mildly affected patients, diffuse white matter damage, which may not be apparent on conventional brain imaging, plays a major role in clinical presentation and cognitive testing. The causes of white matter damage are very different, however, and in later stages of the disease MS and SLE appear to give rise to different forms of cerebral pathology. MS may be characterized by increasing brain atrophy affecting especially the cortical and deep gray matter, at least after conversion to secondary progressive course. There is less evidence for neurodegenerative changes in SLE, but patients are increasingly at risk for cerebrovascular disease. We conclude by offering some suggestions for future clinical and imaging research. KeywordsSystemic lupus erythematosus; Multiple sclerosis; Cognition; Memory; Processing speed; MRI; Effect size Systemic lupus erythematosus (SLE) is a relapsing-remitting autoimmune disease with wide ranging organ involvement and clinical symptoms varying from mild and transient symptoms to death. Cognitive impairment is reported in SLE, even among those patients without documented or overt signs of central nervous system (CNS) involvement. Presumably, cognitive disorder is the result of underlying brain disease although the precise mechanisms remain to be elucidated. The prevalence and degree of cognitive impairment is also uncertain.In this article we will endeavor to evaluate the evidence for neuropsychological impairment in SLE, and to compare the findings with that of MS, another immunological disorder whose symptoms wax and wane and which affects women more than men. Unlike SLE, MS is a disease that always impacts the CNS, and the causes of cognitive disorder in MS are better understood.

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“…In our sample only two of NPSLE and one of SLE patients exhibited hypoperfusion, but the MRI was normal or no available in the rest of patients, medication received was supposed to ameliorate symptoms [28], which deferred in each patient and did not allow standardizing a therapeutic approach.…”

Section: Discussionmentioning

confidence: 86%

Cognitive Impairments in Children with Systemic Lupus and Neuropsychiatric Lupus

Godinez-Villanueva¹,

Yáñez²,

Hernndez-Echeagaray³

2017

J Psychol Psychother

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Objective: The aim of the present study was to determine neurocognitive profile in Children with Systemic (SLE) and Neuropsychiatric Lupus (NPSLE) describing differences in the seven cognitive areas proposed by the ACR (attention, memory, visuospatial processing, language, problem solving, processing speed, and executive function) between children with SLE and those with NPSLE and to understand the level of cognitive deterioration in children afflicted by SLE with and without neuropsychiatric changes. Method:Children with SLE and with NPSLE were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV) and some selected subtests of the Neuropsychological Assessment for Children (NAC), which allowed us to measure the 7 cognitive areas proposed by the ACR. Both, SLE and NPSLE children performances were compared to scores obtained by children without any affection. Results:The area's most affected in the NPSLE group were attention, working memory, processing speed, memory, and visuospatial ability; in the SLE group, the area's most affected were processing speed, visuospatial ability, planning, and auditory memory.Conclusion: Based on our findings, it is concluded that frequently in both groups cognitive decline is present since early stages of illness, being more important in the NPSLE group. These deficiencies are heterogenous and with a multi-domain pattern.

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Corticosteroids and neuropsychological functioning in patients with systemic lupus erythematosus

Cited by 139 publications

References 37 publications

Cognitive Dysfunction in Systemic Lupus Erythematosus: Prevalence and Correlates

Cognitive Dysfunction in Systemic Lupus Erythematosus: Prevalence and Correlates

Neuropsychological Impairment in Systemic Lupus Erythematosus: A Comparison with Multiple Sclerosis

Cognitive Impairments in Children with Systemic Lupus and Neuropsychiatric Lupus

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