Prevalence of Cognitive Impairment in Systemic Lupus Erythematosus

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

doi:10.1097/00005053-198606000-00008

Cited by 228 publications

(208 citation statements)

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“…This would suggest that the incidence of CNS involvement in SLE is greater than has previously been reported (2) and could explain the unexpectedly high incidence of cortical atrophy detected by CT scan and MRI in asymptomatic patients with chronic SLE (3,52). The major role for QEEG evaluations may be in the identification and treatment of early CNS disease.…”

Section: Discussionmentioning

confidence: 92%

“…Estimates of the prevalence of neuropsychiatric SLE (NPSLE) vary between 24% and 75% (1)(2)(3)(4)(5)(6)(7). This variability is partially due to the lack of uniform diagnostic criteria for determining central nervous system (CNS) involve-ment, the inability during acute episodes to obtain tissue for pathologic study, and inherent difficulties in distinguishing primary neurologic and psychiatric abnormalities from those that are secondary to SLE or other organic causes (8)(9)(10).…”

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confidence: 99%

“…These include magnetic resonance imaging (MRI) (3,10,11), computed tomography (CT) scanning (11-13), xenon-133 measurement of regional cerebral blood flow (4,14,15), positron emission tomography (16), and/or neuropsychological assessment (1,2). However, there are several general problems which preclude the routine clinical use of these techniques to diagnose NPSLE.…”

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confidence: 99%

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Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus

Ritchlin

Chabot

Alper

et al. 1992

Arthritis & Rheumatism

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Objective. Neuropsychiatric manifestations are common in patients with systemic lupus erythematosus (SLE), but accurate diagnosis is often difficult. We conducted a prospective study to determine the utility of neurometric quantitative electroencephalography (QEEG) as an indicator of cerebral dysfunction in SLE patients. Methods. Fifty-two SLE patients were divided into 4 groups based on the results of neuropsychiatric evaluations. These included patients with objective evidence of neuropsychiatric SLE (NPSLE), patients with neuropsychiatric symptoms, patients with no evidence of NPSLE, and patients with a prior history of NPSLE. All QEEG findings were compared with data in an age-regressed normative database and with findings in an independent sample of normal subjects.Results. QEEG sensitivity was 87%, and specificity was 75%. QEEG results were abnormal in 74% of the SLE patients with neuropsychiatric symptoms and in 28% of the patients with no evidence of active NPSLE. QEEG profiles varied as a function of the severity and type of neuropsychiatric manifestation present. Within this patient population, QEEG was more sensitive than magnetic resonance imaging, computed tomography scanning, or conventional EEG.Conclusion. Neurometric QEEG may be a sensitive indicator of cerebral dysfunction in patients with NPSLE and can differentiate patients with diverse neuropsychiatric manifestations. When combined with a careful clinical history and evaluation, QEEG provides information that may be useful for the early detection of NPSLE and for serial evaluation of disease activity and treatment efficacy.Neurologic and psychiatric manifestations of systemic lupus erythematosus (SLE) are common, occurring at any time during the illness, and often in the absence of generalized disease activity. Estimates of the prevalence of neuropsychiatric SLE (NPSLE) vary between 24% and 75% (1-7). This variability is partially due to the lack of uniform diagnostic criteria for determining central nervous system (CNS) involve-

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

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confidence: 99%

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Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus

Ritchlin

Chabot

Alper

et al. 1992

Arthritis & Rheumatism

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“…Seizures, neuropathies, hemiparesis, organic brain syndrome, psychosis, and depression, as well as paresthesias, headaches, anxiety, and mood swings can occur in SLE (9,19). Several groups of investigators have drawn attention to cognitive deterioration as an independent expression of nervous system involvement in SLE, in addition to neurologic and psychiatric manifestations (20)(21)(22)(23)(24)(25)(26)(27). Since the whole spectrum of nervous system derangement can occur as a result of SLE, neurologic, psychiatric, and cognitive functioning was assessed in our patients with chronic NPSLE.…”

Section: Resultsmentioning

confidence: 99%

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Bosma¹,

Middelkoop²,

Rood³

et al. 2002

Arthritis & Rheumatism

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Objective. To investigate the relationship between quantitative estimates of global brain damage based on magnetization transfer imaging (MTI) and cerebral functioning, as measured by neurologic, psychiatric, and cognitive assessments, as well as disease duration in patients with a history of neuropsychiatric systemic lupus erythematosus (NPSLE).Methods. In patients with systemic lupus erythematosus (SLE), neurologic, psychiatric, and psychological symptoms often occur. The frequency of nervous system involvement has been reported to range from 11% to 60% (1). Infection, drug side effects, hypertension, or metabolic derangements, as well as an intrinsic brain manifestation of SLE (i.e., neuropsychiatric SLE [NPSLE]), can cause such symptoms. The uncertain pathogenesis and the wide variety of manifestations of NPSLE complicate the development of a uniform diagnostic decision-making protocol and a uniform method of monitoring a patient with this type of SLE. Findings of routine brain imaging studies are often unremarkable in patients with NPSLE, or the studies reveal abnormalities, such as cerebral atrophy and white matter hyperintensities (on magnetic resonance imaging [MRI]), that can also be found in SLE patients without neuropsychiatric symptoms. Furthermore, no correlation has thus far been demonstrated between quantitative measures of such nonspecific abnormalities and measures of brain function (2-5).Recently, magnetization transfer ratio (MTR) histogram analysis, a quantitative MRI technique based on magnetization transfer imaging (MTI), was applied in patients with primary NPSLE but without abnormalities on MRI that could account for the clinical picture. With this technique, cerebral abnormalities were identified in these patients (6,7). Such abnormalities were found in SLE patients who had had episodes of neuropsychiatric symptoms in the past (chronic NPSLE) as well as in patients who were experiencing an active phase of neuropsychiatric symptoms (active NPSLE) (6,7). The

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“…Cross-sectional studies (1-6) have defined the characteristics of cognitive dysfunction and its prevalence, which has varied from 21% to 66% due t o differences in study populations, the particular neuropsychological tests used, and the definition of cognitive impairment. Most studies have identified subclinical cognitive dysfunction in a substantial proportion of patients (1)(2)(3)(4). It is important to know whether these abnormalities in cognitive function progress over time to more profound cognitive dysfunction or whether they signal the eventual emergence of other clinically overt manifestations of neuropsychiatric SLE (NPSLE).…”

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confidence: 99%

Cognitive function in systemic lupus erythematosus: Results of a 5‐year prospective study

Hanly

Cassell

Fisk

1997

Arthritis & Rheumatism

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Prevalence of Cognitive Impairment in Systemic Lupus Erythematosus

Cited by 228 publications

References 0 publications

Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus

Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Cognitive function in systemic lupus erythematosus: Results of a 5‐year prospective study

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