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Cognitive dysfunction and white matter abnormalities in antiphospholipid syndrome.

Doruk Erkan¹, Elizabeth Kozora, Michael D Lockshin

¹The Barbara Volcker Center for Women and Rheumatic Disease, United States; Hospital for Special Surgery, United States; Weill Medical College of Cornell University, United States.

Pathophysiology : the Official Journal of the International Society for Pathophysiology

|May 18, 2010

Summary

Antiphospholipid antibody-positive patients may experience cognitive issues and white matter changes on MRI. Further research using advanced neuroimaging could clarify the link between these MRI findings and cognitive impairment.

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Area of Science:

Neurology
Immunology
Radiology

Background:

Antiphospholipid syndrome (APS) diagnosis requires clinical events and positive antiphospholipid antibodies (aPL).
Neurologic manifestations of APS commonly include stroke and transient ischemic attack.
Cognitive dysfunction and MRI white matter hyperintensities are observed in aPL-positive individuals, irrespective of APS diagnosis.

Purpose of the Study:

To investigate the cognitive patterns associated with antiphospholipid antibodies (aPL).
To explore the relationship between MRI-detected white matter hyperintensities and cognitive function in aPL-positive patients.
To understand the potential of advanced neuroimaging in elucidating cognitive dysfunction in this population.

Main Methods:

Review of existing literature on antiphospholipid antibodies (aPL), antiphospholipid syndrome (APS), cognitive function, and neuroimaging.
Analysis of magnetic resonance imaging (MRI) findings, specifically white matter hyperintensities.
Correlation of neuroimaging data with observed cognitive deficits.

Main Results:

Cognitive dysfunction and MRI white matter hyperintensities are present in aPL-positive patients.
A potential link exists between white matter hyperintensities and attentional/executive cognitive impairment.
The precise cognitive pattern in aPL-positive patients remains incompletely understood.

Conclusions:

White matter hyperintensities on MRI may indicate underlying cognitive impairment in aPL-positive individuals.
Sophisticated neuroimaging studies are needed to further understand cognitive dysfunction in aPL-positive patients.
Clarifying these relationships can improve the diagnosis and management of conditions associated with aPL.