Patients with systemic lupus erythematosus (SLE) demonstrate impairment of sustained attention, according to a new study.
The research, carried out by the University of Manchester, compared cognitive function in SLE patients with stable disease and healthy controls (HCs) using both behavioural and neuroimaging techniques. Neurocognitive function was assessed using tests from the Cambridge Neuropsychological Test Automated Battery, and functional MRI was used to examine brain responses to working memory (WM) and emotional processing (facial emotional recognition task) tasks.
Compared with HCs (n=30), patients with SLE (n=36) scored higher on measures of depression and fatigue and had higher high sensitivity C reactive protein (P=.013), interleukin 6 (P=.003) and B lymphocyte stimulator (P<.001).
Patients with SLE had poorer performance on a task of sustained attention (P=.002) and had altered brain responses, particularly in default mode network (DMN) regions and the caudate, during the WM task.
Higher organ damage and higher vascular cell adhesion molecule-1 were associated with less attenuation of the DMN (P=.005 and P=.01, respectively).
The authors say the data suggest that in addition to mood and fatigue, inflammatory mechanisms and organ damage impact cognitive functioning in SLE. The multifaceted nature of cognitive decline in SLE means any therapeutic interventions should be individually tailored, they say.
The study is published in the Annals of the Rheumatic Diseases.
