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Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and
Michelle Barraclough1,2, Shane McKie3, Ben Parker2,4
1Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Annals of the Rheumatic Diseases
|April 14, 2019
Summary
Systemic lupus erythematosus (SLE) patients show impaired sustained attention and altered brain activity, particularly in default mode network regions. Inflammatory markers and organ damage contribute to cognitive dysfunction in SLE.
Area of Science:
- Neuroscience
- Immunology
- Rheumatology
Background:
- Cognitive dysfunction is prevalent in systemic lupus erythematosus (SLE).
- The underlying causes of cognitive dysfunction in SLE remain poorly understood.
- Limited treatment options exist for cognitive impairment in SLE patients.
Purpose of the Study:
- To compare cognitive function between SLE patients and healthy controls (HCs).
- To investigate behavioral and neuroimaging correlates of cognitive dysfunction in SLE.
- To identify potential biomarkers and contributing factors to cognitive impairment in SLE.
Main Methods:
- Recruited SLE patients with stable disease and HCs.
- Collected clinical, psychological data, and blood biomarkers.
- Assessed neurocognitive function using CANTAB and fMRI during working memory and emotional processing tasks.
Main Results:
- SLE patients exhibited higher depression, fatigue, and inflammatory markers (hsCRP, IL-6, B lymphocyte stimulator) compared to HCs.
- SLE patients showed poorer sustained attention and altered brain responses in default mode network (DMN) and caudate regions during working memory tasks.
- Higher organ damage and VCAM-1 levels correlated with impaired DMN attenuation and reduced caudate BOLD signal in SLE patients.
Conclusions:
- Sustained attention is impaired in SLE patients.
- Altered DMN activity and inflammatory mechanisms, alongside organ damage, contribute to cognitive dysfunction in SLE.
- Tailored therapeutic interventions are necessary due to the multifaceted nature of cognitive dysfunction in SLE.
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