2006 issue 3

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Volume 15, issue 3

Review article

Cognitive impairment in systemic lupus erythematosus

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 (3): 155-183
Keywords: systemic lupus erythematosus, cognitive dysfunction

Abstract

Objective. The article presents the first part of a review of major research findings concerning cognitive function impairment in patients with systemic lupus erythematosus (SLE).

Review. SLE is an inflammatory disease of autoimmunological origin, characterized by periods of exacerbation and remission. A variety of symptoms can be seen in the course of SLA, including these of both peripheral and central nervous system dysfunction. Due to the diversity of neurological and psychiatric symptoms in SLA patients attempts have been made to group these symptoms together, and eventually a classification was developed. It was published by the American College of Rheumatology (ACR) in 1999. The classification includes cognitive impairment symptoms, at present regarded as one of the most frequent manifestations of SLA, seen in 80% of these patients. Results of studies on the prevalence of cognitive deficits in SLA had been discrepant (with estimates ranging from 21 to 71 %) until the ACR classification was published. The discrepancies resulted probably from a lack of uniform diagnostic criteria for cognitive impairment, and from using different methods for the assessment of cognitive functions. Rather few prospective studies conducted so far did not bring any clear-cut conclusions, since although in most cases cognitive deficits show some stability, nevertheless both a significant improvement and exacerbation of SLA patients' cognitive functioning have been reported.

Conclusions. Cognitive impairment belongs to the most common symptoms of the nervous system dysfunction in SLA patients. Since no conclusive findings have been obtained from prospective studies, further research into cognitive functions in SLA is needed. Psychological assessment is regarded as an indispensable element of the diagnostic process in SLA patients.

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