Neuropsychological assessment in systemic lupus erythematosus patients: clinical usefulness of first-choice diagnostic tests in detecting cognitive impairment and preliminary diagnosis of neuropsychiatric lupus

作者：Nowicka Sauer K^*; Czuszynska Z; Smolenska Z; Siebert J

来源：Clinical and Experimental Rheumatology, 2011, 29(2): 299-306.

• systemic lupus erythematosus
• cognitive disorders
• neuropsychological tests

Objective
To evaluate the usefulness of neuropsychological tests in order to distinguish the first-choice methods useful in quick detection of cognitive impairment in SLE and preliminary diagnosis of neuropsychiatric manifestation. Study aimed at assessment of the prevalence and severity of cognitive deficits in SLE patients and comparison between SLE patients with neuropsychiatric manifestations (NP-SLE) and without ones (non-NP-SLE).
Methods
93 out of 104 SLE patients, 57 with NP-SLE and 36 with non-NP-SLE underwent comprehensive neuropsychological examination. Tailor-made structured interview for neuropsychological assessment in SLE (SISLE) was used. Patients' emotional state was assessed by clinical interview and HADS.
Results
Cognitive dysfunction was identified in 57% of SLE patients, 48.4% in 1-3 tests, 8.6% (8 patients) in 4 or more tests (severe decline). Among impaired patients 15% had severe decline. In NP-SLE group 63.2% were impaired vs. 47.2% in non-NP-SLE group. All 8 patients with severe decline were NP-SLE. The dysfunction was irrespective of premorbid intellectual level, age, education, disease duration and steroid treatment. In NP-SLE significantly lower scores were observed in 8 tests (10 parameters).
Conclusion
Cognitive dysfunction is frequent in SLE patients. The majority of patients has mild deficits, but severe decline is also observed. The dysfunction is more frequent and more pronounced in NP-SLE. The study distinguished 8-test-first-choice-battery useful in detecting cognitive impairment in SLE and in case of severe decline - in preliminary differentiating NP-SLE and non-NP-SLE. Structured interview for psychologicallneuropsychological examination of SLE patients is a useful and required tool for a standard patients' assessment.

• 出版日期2011-4