Cognitive dysfunction in systemic lupus erythematosus: Insights from a two-year longitudinal study in a Brazilian cohort

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica Pub Date : 2025-08-01 DOI:10.1016/j.reuma.2025.501941

Eduarda Scoto Dias , José Henrique Tercziany Vanzin , Eduardo Augusto Borba , Mahara Freitas dos Santos , Thiago Alberto F.G. dos Santos , Thelma Skare , Renato Nisihara

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Abstract

Objectives

The objective of this study was to examine cognitive dysfunction in a Brazilian sample of SLE patients for two years.

Methods

A sample of 50 individuals with SLE was assessed at baseline for epidemiological and treatment data, disease activity by SLEDAI 2K (SLE disease activity 2000), cumulative damage by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), depression by CES-D (Center for Epidemiological Studies-Depression) and cognitive function through MoCA (Montreal Cognitive Assessment). The same assessment was repeated after two years.

Results

The prevalence of cognitive impairment at baseline was 68%. The baseline cognitive assessment showed impairment in visuospatial/executive function (p = 0.002), naming (p = 0.04), attention (p < 0.0001) and delayed recall (p < 0.0001). The median MoCA results did not change in two years (p = 0.45), but 6 individuals (12%) that had normal cognitive function at baseline developed mild cognitive impairment and two (4%) that had mild cognitive impairment, improved. When considering the MoCA domains the only significant difference was improvement in abstraction (p = 0.001). No correlations between MoCA delta (difference between second and first value) and delta SLEDAI, delta SLICC and delta CES-D were found (all with p > 0.05). Also, no associations were found with used treatment or autoantibodies profile.

Conclusions

Cognitive dysfunction in SLE is dynamic and may require periodic re-assessments. Changes in cognition were not associated with disease activity, depression or cumulative damage in this sample.

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系统性红斑狼疮的认知功能障碍：来自巴西一项为期两年的纵向研究的见解

本研究的目的是研究巴西SLE患者两年的认知功能障碍。方法50例SLE患者在基线时进行流行病学和治疗资料评估，疾病活动性通过SLEDAI 2K （SLE疾病活动性2000）评估，累积损害通过SLICC/ACR DI（系统性狼疮国际合作诊所/美国风湿病学会损伤指数）评估，抑郁通过CES-D（抑郁症流行病学研究中心）评估，认知功能通过MoCA（蒙特利尔认知评估）评估。两年后又进行了同样的评估。结果基线时认知障碍患病率为68%。基线认知评估显示视觉空间/执行功能（p = 0.002）、命名（p = 0.04）、注意力(p <；0.0001)和延迟召回(p <；0.0001)。MoCA的中位数结果在两年内没有变化（p = 0.45），但6名（12%）基线认知功能正常的患者出现轻度认知障碍，2名（4%）轻度认知障碍患者出现改善。当考虑MoCA域时，唯一显著的差异是抽象的改善（p = 0.001）。MoCA δ（二值与一值之差）与δ SLEDAI、δ SLICC和δ CES-D之间无相关性(均为p >；0.05)。此外，未发现与使用的治疗方法或自身抗体谱相关。结论SLE患者的认知功能障碍是动态的，可能需要定期重新评估。在这个样本中，认知的改变与疾病活动、抑郁或累积损伤无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reumatologia Clinica RHEUMATOLOGY-

CiteScore

2.40

自引率

6.70%

发文量

105

审稿时长

54 days

期刊介绍： Una gran revista para cubrir eficazmente las necesidades de conocimientos en una patología de etiología, expresividad clínica y tratamiento tan amplios. Además es La Publicación Oficial de la Sociedad Española de Reumatología y del Colegio Mexicano de Reumatología y está incluida en los más prestigiosos índices de referencia en medicina.