2006 issue 4

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Volume 15, issue 4

Review article

Cognitive dysfunctions in systemic lupus erythematosus: relationship to selected clinical characteristics

KATARZYNA NOWICKA-SAUER1, ZBIGNIEW NOWICKI2
1. Katedry i Zakładu Medycyny Rodzinnej Akademii Medycznej w Gdańsku
2. Zakładu Psychiatrii Biologicznej Katedry Chorób Psychicznych Akademii Medycznej w Gdańsku
Postępy Psychiatrii i Neurologii 2006; 15 (4): 295-276
Keywords: systemic lupus erythematosus, cognitive dysfunction, neuropsychiatry manifestation, disease activity level, autoantibodies, steroid usage
Abstract

Background. The article presents research findings concerning the relationship between cognitive dysfunctions in patients with systemic lupus erythematosus (SLE) and: their disease activity level, concomitant neurological and/or psychiatric (N/P) symptoms, results of neuroimaging scanning, selected immunological indicators, and steroid treatment.

Review. Cognitive dysfunctions in SLE patients are irrespective of either the disease activity level or steroid treatment administered in these cases, but they are often associated with increased levels of anticardiolipin antibodies. Concomitant neurological and/or psychiatric symptoms seem to be another factor contributing to the presence of cognitive dysfunctions, although no evidence has been found to suggest that cognitive deficits in SLE are associated with mood disorders. It should be noted that cognitive dysfunctions occur also in patients who have never manifested any N/P symptoms. Cognitive deficits seem to be associated with changes in magnetic resonance imaging (MRI), magnetization transfer imaging (MTI) and positron emission tomography (PET) scans. However, conclusions from studies seeking a correlation between cognitive dysfunctions and cerebral blood flow abnormalities measured using the single photon emission tomography (SPECT) are discrepant.

Conclusions. Cognitive dysfunctions are a frequent manifestation in SLE, seen both in patients with N/P symptoms and in those without such symptoms. The dysfunctions in the latter group are regarded as a symptom of subclinical impairment of the central nervous system. Due to discrepancy of research results this problem remains under investigation in many studies.

Address for correspondence:
Dr Katarzyna Nowicka-Sauer, Katedra i Zakład Medycyny Rodzinnej Akademii Medycznej,
ul. Dębinki 2, 80-211 Gdańsk, e-mail: kpsauer@amg.gda.pl