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THU0017 Cognitive Dysfunction in Active and Remitted Egyptian Non-Neuropsychiatric Systemic Lupus Erythematosus Patients
  1. N.O. El-Azizi1,
  2. E.M. Shorub2,
  3. M. Sabry3,
  4. A.S. Shalash4
  1. 1Internal Medicine & Rheumatology
  2. 2Psychiatry
  3. 3Clinical Pathology
  4. 4Neurology, Ain Shams University, Cairo, Egypt

Abstract

Background Few studies reported mild cognitive deficits in patients with Non-Neuropsychiatric Systemic Lupus Erythematosus (Non-NPSLE) with no consistent pattern of cognitive deficits with suggest of the presence of a subtle CNS disorder 1,2,3.

Objectives To determine the pattern of the cognitive dysfunction in Egyptian patients Non-NPSLE in both active and remission states by applying a battery of neuropsychological tests.

Methods Fifty patients with Non-NPSLE (25 patients in activity and 25 in remissions) were evaluated for cognitive dysfunction and compared with 25 healthy controls matched for age, sex and education. The activity of SLE disease was assessed. Each subject was subjected clinical (general, neurological and psychiatric) assessment, laboratory evaluation and battery of neuropsychological tests for assessing the cognitive functions including, the Wechsler adults Intelligence Scale (WAIS) to measure intellectual performance, the Wechsler Memory Scale (WMS) to measure different memory functions, the Wisconsin Card Sorting Test (WCST) to measure of executive function, Trail Making test (TMT) for testing visual attention, psychomotor speed and task switching.

Results Compared to controls, Non-NPSLE patients in remission had worse cognitive domains of working memory, visual-constructional abilities and executive function (p<0.005). The active group showed poorer performance in specific areas of cognitive function than the remission group at the time of testing including, working, short and recent memory (p=0.000), logical reasoning, perception, sustained attention (p=0.003), visuo-constructional abilities (p=0.001) and executive function (p<0.001). Furthermore, cognitive impairment was significantly correlated with disease activity measured by SLAM score.

Conclusions Patients with non-NPSLE suffered from dysfunction of multiple cognitive domains that could be detected by neuropsychological tests. Moreover, cognitive dysfunctions worsen and expand in patients with active disease and are dependent mainly on disease activity.

References

  1. Hanly JG, Fisk JD, Sherwood G, et al., (1992): Cognitive impairment in patients with Systemic Lupus Erythematosus. J Rheumatol; 19: 562-7.

  2. Carlomagno S, Migliaresi S, Ambrosone L, et al., (2000): Cognitive impairment in systemic lupus Erythematosus: a follow-up study. J Neurology; 247: 273-9.

  3. Monastero R, Bettini P, Del Zotto E, et al., (2001): Prevalence and pattern of cognitive impairment in Systemic Lupus Erythematosus patients with and without overt neuropsychiatric manifestations. J Neurol Sci; 184: 33-9.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.1317

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