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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Cognitive dysfunction and white matter abnormalities in systemic lupus erythematosus.

Elizabeth Kozora¹, Christopher M Filley²

¹1National Jewish Health, Denver, Colorado.

Journal of the International Neuropsychological Society : JINS

|February 23, 2011

Summary

Systemic lupus erythematosus (SLE) can cause brain abnormalities, including mild cognitive dysfunction (MCD-SLE) linked to early white matter damage. Advanced neuroimaging reveals subtle changes preceding more severe neuropsychiatric lupus (NPSLE) symptoms.

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Area of Science:

Neurology
Immunology
Neuroimaging

Background:

Brain abnormalities are documented in systemic lupus erythematosus (SLE) patients via neuropsychological assessment and neuroimaging.
Conventional neuroimaging in neuropsychiatric SLE (NPSLE) often shows white matter hyperintensities, infarcts, hemorrhages, and atrophy.

Purpose of the Study:

To investigate associations between microstructural white matter abnormalities and cognitive function in SLE patients without overt neuroimaging findings.
To explore the potential of early myelinopathy in mild cognitive dysfunction in SLE (MCD-SLE).

Main Methods:

Utilized sophisticated neuroimaging techniques in SLE patients.
Correlated neuroimaging findings with neuropsychological assessments focusing on attention, executive function, and processing speed.

Main Results:

Sophisticated neuroimaging revealed associations between microstructural white matter abnormalities and impaired attention, executive function, and processing speed in SLE patients.
These subtle WM abnormalities and associated cognitive deficits (MCD-SLE) may precede more severe NPSLE.

Conclusions:

Mild cognitive dysfunction in SLE (MCD-SLE) may stem from early myelinopathy, detectable through advanced neuroimaging.
Microstructural white matter changes are linked to cognitive impairment in SLE, even without conventional neuroimaging abnormalities.