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Abstract Number: 2654

Cognitive Function in Systemic Lupus Erythematosus Patients with Past History of Neuropsychiatric Manifestations : A Longitudinal Study

Yang Gao1, Yi Lo1, Jacky Wan2, Esther YY Lau2 and Mo Yin Mok1, 1Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong, 2Department of Psychology, University of Hong Kong, Hong Kong, Hong Kong

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Anxiety, Cognitive dysfunction, longitudinal studies, neuropsychiatric disorders and systemic lupus erythematosus (SLE)

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Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Epidemiology, Women's Health, Cardiovascular and CNS

Session Type: Abstract Submissions (ACR)

Background/Purpose: Cognitive impairment is commonly reported in patients with systemic lupus erythematosus (SLE) and its associations with neuropsychiatric involvement (NPSLE) and psychiatric factors have been inconsistently reported in the literature.

Objective: To evaluate full neurocognitive function in relation to psychiatric factors including anxiety and depression in NPSLE patients longitudinally compared to matched controls.

Methods: Cognitive symptom inventory (CSI) was used to measure perceived cognitive impairment whereas full neurocognitive battery that covered 8 cognitive domains were performed by trained psychologist at 2 time-points 12 months apart. Depressive and anxiety symptoms were measured by HADS.

Results: 18 NPSLE and 18 non-NPSLE patients matched to age, sex and disease duration as well as 16 age- and sex- matched healthy subjects were recruited. NPSLE patients consistently reported more cognitive impairment and anxiety symptoms than non-NPSLE patients over both time-points. NPSLE patients had worse performance on 3 memory tests whereas non-NPSLE patients only showed significantly lower AVLT recognition compared with healthy subjects by post-hoc analysis. Applying age- and education- adjusted Chinese norms, NPSLE patients had significantly worse performance than non-NPSLE patients over 5 cognitive domains including simple and complex attention, memory, reasoning and visuospatial function which remained significant when adjusted for HADS-A. Anxiety contributed only to AVLT delay recall in regression analysis. Longitudinal analysis revealed improvement in some cognitive tests by non-NPSLE patients at re-evaluation whereas NPSLE patients did not show any difference in serial test performance.

Conclusion: Compared to non-NPSLE patients, NPSLE patients reported more cognitive and anxiety symptoms and had significantly worse cognitive functions involving simple and complex attention, memory, reasoning and visuospatial domains. Unlike non-NPSLE patients, they failed to demonstrate learning effect upon re-evaluation over 12 months.


Disclosure:

Y. Gao,
None;

Y. Lo,
None;

J. Wan,
None;

E. Y. Lau,
None;

M. Y. Mok,
None.

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