Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Cognitive Dysfunction in Patients with SLE: A Prospective Study.
Piatti2, Andres, Adhikari2, Tara, Luggen1, Michael
Cognitive dysfunction (CD) has been reported to occur frequently in SLE. It is unclear, however, it this CD is transient, persistent, or progressive. Published reports have estimated persistence or progression in anywhere from 17% to 93% of patients. These widely divergent results may be due in part to the definition of CD and the control population employed. Chronic rheumatic diseases cause pain, fatigue, and depression which may affect cognitive function. All studies of progression to date have employed normal healthy individuals as controls. Definitions of CD relative to this population will identify some pts whose major problems are depression, pain, or fatigue, which may improve, and some who have structural CNS disease, which may not. Previous work from our group utilizing an age, sex, and race matched RA control population and a community based cohort of SLE pts suggested that the frequency of CD was low (17.2%), but that most patients had persistent deficits. This work extends those observations.
Patients with SLE by ACR Criteria from several sources were examined at baseline and again after >= 6 months. Cognitive function was assessed by the ANAM (Automated Neuropyschologic Assessment Metrics), a validated, computerized, cognitive testing battery, utilizing as the primary outcome measure the total throughput score (TTS=total number of correct responses/time). Disease activity, damage, and treatment variables were ascertained at baseline and at 6 mos. Abnormality was defined as having scores 1.5 SD below the mean of a comparable RA control population. Results were compared using paired t-tests or Wilcoxon sign rank test and by Fisher's exact test.
Thirty-eight (38) patients have been examined to date on at least 2 occasions. Four (10.6%) had CD at baseline. CD persisted in all pts at 6 mos. None, however, showed progression and no additional subjects developed CD. Pts with CD were significantly older than those without (58.3 ± 8.9 vs 44.1 ± 9.0, p < 0.05). Other differences were found but none were statistically significant, perhaps due to small numbers with CD. TTS improved significantly in those without CD (increase of 9.4% (95% CI: 0.1%, 19.0%) but decreased in those with CD by 4.0% (95% CI: -13.9%, 5.8%).
Using RA controls, 10.6% of SLE pts had CD and all remained unchanged over a 6 month interval. Age was a significant correlate of CD. Pts without CD improved scores over 6 mos perhaps demonstrating a learning effect. Those with CD had no such improvement. This may represent another measure of CD.
To cite this abstract, please use the following information:
Piatti, Andres, Adhikari, Tara, Luggen, Michael; Cognitive Dysfunction in Patients with SLE: A Prospective Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1854