Subclinical cognitive dysfunction in systemic lupus erythematosus patients: Insights from clinical and electrophysiological measures

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist Pub Date : 2025-09-06 DOI:10.1016/j.ejr.2025.09.001

Esraa M. Seif El-Din , Ahmed K. Mohamed , Dina F. Osman

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Abstract

Background

Cognitive dysfunction is common in systemic lupus erythematosus (SLE) with considerable impact on patients’ quality of life.

Aim of the work

To evaluate cognitive function in SLE patients with (NPSLE) and without (non-NPSLE) neuropsychiatric involvement and their association with disease parameters.

Patients and methods

The study included 30 SLE patients (15 NPSLE and 15 non-NPSLE) and 30 matched controls. Cognitive evaluation included the mini-mental state examination (MMSE), symbol digit modalities test (SDMT) and electrophysiological event-related potentials (P300). Audiological assessment was performed. The SLE disease activity index (SLEDAI) was assessed.

Results

Patients were 26 females and 4 males with a mean of age of 36.4 ± 6.3 years. All patients had a prolonged P300 latency, reduced P300 amplitude, lower MMSE and SDMT scores compared to the control (408.9 ± 40.08 vs 313.8 ± 10.72, 3.63 ± 0.8 vs 4.85 ± 0.9, 26.6 ± 1.1vs 29.17 ± 0.8 and 35.1 ± 3.06 vs 50.47 ± 2.54, all p < 0.001). The SDMT was significantly lower in NPSLE (33.80 ± 3.61) compared to non-NPSLE (36.4 ± 1.68,p = 0.03) patients. There was a significant correlation between MMSE and P300 latency in NPSLE and non-NPSLE groups (r = -0.54, p = 0.03 and r = -0.84, p < 0.001 respectively). Cognitive performance via MMSE negatively correlated with disease duration in both NPSLE and non-NPSLE (r = -0.553,p = 0.032 and r = -0.784,p = 0.001 respectively) as well as P300 latency negatively correlated significantly with disease duration in the non-NPSLE (r = 0.764,p = 0.001). The SDMT had significant predictive ability in differentiating NPSLE from non-NPSLE (sensitivity 73.3 % and specificity 60 %,p = 0.023).

Conclusion

Cognitive impairment is frequent in SLE patients, regardless of neuropsychiatric involvement. Early cognitive screening is warranted, and chronic disease progression rather than activity may underlie cognitive deficits.

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系统性红斑狼疮患者的亚临床认知功能障碍：来自临床和电生理测量的见解

认知功能障碍在系统性红斑狼疮（SLE）中很常见，对患者的生活质量有相当大的影响。研究目的评估合并（NPSLE）和未合并（非NPSLE）神经精神疾病累及的SLE患者的认知功能及其与疾病参数的关系。患者和方法该研究包括30例SLE患者（15例NPSLE和15例非NPSLE）和30例匹配的对照。认知评价包括最小精神状态检查（MMSE）、符号数字模态测试（SDMT）和电生理事件相关电位（P300）。进行听力学评估。评估SLE疾病活动指数（SLEDAI）。结果女性26例，男性4例，平均年龄36.4±6.3岁。与对照组相比，所有患者P300潜伏期延长，P300振幅降低，MMSE和SDMT评分降低（408.9±40.08 vs 313.8±10.72,3.63±0.8 vs 4.85±0.9,26.6±1.1vs 29.17±0.8和35.1±3.06 vs 50.47±2.54，均p <； 0.001）。NPSLE患者的SDMT（33.80±3.61）明显低于非NPSLE患者（36.4±1.68,p = 0.03）。NPSLE组和非NPSLE组的MMSE与P300潜伏期有显著相关性（r = -0.54, p = 0.03和r = -0.84, p < 0.001）。NPSLE和非NPSLE患者的MMSE认知表现与病程呈负相关（r = -0.553,p = 0.032和r = -0.784,p = 0.001），非NPSLE患者的P300潜伏期与病程呈显著负相关（r = 0.764,p = 0.001）。SDMT在区分NPSLE和非NPSLE方面具有显著的预测能力（敏感性73.3%，特异性60%，p = 0.023）。结论认知障碍在SLE患者中很常见，与神经精神疾病无关。早期认知筛查是必要的，慢性疾病进展而不是活动可能是认知缺陷的基础。

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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