Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus

A prospective study

Katsuji Nishimura, Masako Omori, Yasuhiro Katsumata, Eri Sato, Takahisa Gono, Yasushi Kawaguchi, Masayoshi Harigai, Masaru Mimura, Hisashi Yamanaka, Jun Ishigooka

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective. Neurocognitive impairment (NCI) has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which may itself induce NCI. We investigated NCI in corticosteroid-naive people with SLE who did not exhibit any overt neuropsychiatric manifestations. Methods. Forty-three inpatients with SLE who had no current or past neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic characteristics were given a 1-h battery of neuropsychological tests. NCI was defined as scores at least 2 SD below the mean of the healthy control group on at least 2 of the 7 neurocognitive domains. Results of clinical, laboratory, and neurologic tests were compared regarding the presence of NCI. Results. NCI was identified in 12 patients (27.9%) with SLE and in 2 control subjects (6.7%). Patients with SLE showed a significant impairment compared with controls on tasks assessing immediate recall, complex attention/executive function, and psychomotor speed. We identified psychomotor speed (Digit Symbol Substitution Test) as the factor that best differentiated the 2 groups. Further, we identified the score of the SLE Disease Activity Index 2000 as an independent risk factor for NCI in patients with SLE. Conclusion. We conclude that reduced psychomotor speed is an SLE-specific pattern of NCI. Verbal-memory deficits that have been reported in patients with SLE were not evident among patients who were corticosteroid-naive. Our results indicate that impaired psychomotor speed may be added to the symptoms of early SLE.

Original languageEnglish
Pages (from-to)441-448
Number of pages8
JournalJournal of Rheumatology
Volume42
Issue number3
DOIs
Publication statusPublished - 2015 Mar 1

Fingerprint

Systemic Lupus Erythematosus
Adrenal Cortex Hormones
Prospective Studies
Neuropsychological Tests
Executive Function
Memory Disorders
Short-Term Memory
Nervous System
Inpatients
Healthy Volunteers
History
Demography
Control Groups

Keywords

  • Corticosteroids
  • Neurocognitive impairment
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Nishimura, K., Omori, M., Katsumata, Y., Sato, E., Gono, T., Kawaguchi, Y., ... Ishigooka, J. (2015). Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus: A prospective study. Journal of Rheumatology, 42(3), 441-448. https://doi.org/10.3899/jrheum.140659

Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus : A prospective study. / Nishimura, Katsuji; Omori, Masako; Katsumata, Yasuhiro; Sato, Eri; Gono, Takahisa; Kawaguchi, Yasushi; Harigai, Masayoshi; Mimura, Masaru; Yamanaka, Hisashi; Ishigooka, Jun.

In: Journal of Rheumatology, Vol. 42, No. 3, 01.03.2015, p. 441-448.

Research output: Contribution to journalArticle

Nishimura, K, Omori, M, Katsumata, Y, Sato, E, Gono, T, Kawaguchi, Y, Harigai, M, Mimura, M, Yamanaka, H & Ishigooka, J 2015, 'Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus: A prospective study', Journal of Rheumatology, vol. 42, no. 3, pp. 441-448. https://doi.org/10.3899/jrheum.140659
Nishimura, Katsuji ; Omori, Masako ; Katsumata, Yasuhiro ; Sato, Eri ; Gono, Takahisa ; Kawaguchi, Yasushi ; Harigai, Masayoshi ; Mimura, Masaru ; Yamanaka, Hisashi ; Ishigooka, Jun. / Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus : A prospective study. In: Journal of Rheumatology. 2015 ; Vol. 42, No. 3. pp. 441-448.
@article{429ad2ec6f7747feac2606b45f5e5ae1,
title = "Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus: A prospective study",
abstract = "Objective. Neurocognitive impairment (NCI) has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which may itself induce NCI. We investigated NCI in corticosteroid-naive people with SLE who did not exhibit any overt neuropsychiatric manifestations. Methods. Forty-three inpatients with SLE who had no current or past neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic characteristics were given a 1-h battery of neuropsychological tests. NCI was defined as scores at least 2 SD below the mean of the healthy control group on at least 2 of the 7 neurocognitive domains. Results of clinical, laboratory, and neurologic tests were compared regarding the presence of NCI. Results. NCI was identified in 12 patients (27.9{\%}) with SLE and in 2 control subjects (6.7{\%}). Patients with SLE showed a significant impairment compared with controls on tasks assessing immediate recall, complex attention/executive function, and psychomotor speed. We identified psychomotor speed (Digit Symbol Substitution Test) as the factor that best differentiated the 2 groups. Further, we identified the score of the SLE Disease Activity Index 2000 as an independent risk factor for NCI in patients with SLE. Conclusion. We conclude that reduced psychomotor speed is an SLE-specific pattern of NCI. Verbal-memory deficits that have been reported in patients with SLE were not evident among patients who were corticosteroid-naive. Our results indicate that impaired psychomotor speed may be added to the symptoms of early SLE.",
keywords = "Corticosteroids, Neurocognitive impairment, Systemic lupus erythematosus",
author = "Katsuji Nishimura and Masako Omori and Yasuhiro Katsumata and Eri Sato and Takahisa Gono and Yasushi Kawaguchi and Masayoshi Harigai and Masaru Mimura and Hisashi Yamanaka and Jun Ishigooka",
year = "2015",
month = "3",
day = "1",
doi = "10.3899/jrheum.140659",
language = "English",
volume = "42",
pages = "441--448",
journal = "Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "3",

}

TY - JOUR

T1 - Neurocognitive impairment in corticosteroid-naive patients with active systemic lupus erythematosus

T2 - A prospective study

AU - Nishimura, Katsuji

AU - Omori, Masako

AU - Katsumata, Yasuhiro

AU - Sato, Eri

AU - Gono, Takahisa

AU - Kawaguchi, Yasushi

AU - Harigai, Masayoshi

AU - Mimura, Masaru

AU - Yamanaka, Hisashi

AU - Ishigooka, Jun

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Objective. Neurocognitive impairment (NCI) has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which may itself induce NCI. We investigated NCI in corticosteroid-naive people with SLE who did not exhibit any overt neuropsychiatric manifestations. Methods. Forty-three inpatients with SLE who had no current or past neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic characteristics were given a 1-h battery of neuropsychological tests. NCI was defined as scores at least 2 SD below the mean of the healthy control group on at least 2 of the 7 neurocognitive domains. Results of clinical, laboratory, and neurologic tests were compared regarding the presence of NCI. Results. NCI was identified in 12 patients (27.9%) with SLE and in 2 control subjects (6.7%). Patients with SLE showed a significant impairment compared with controls on tasks assessing immediate recall, complex attention/executive function, and psychomotor speed. We identified psychomotor speed (Digit Symbol Substitution Test) as the factor that best differentiated the 2 groups. Further, we identified the score of the SLE Disease Activity Index 2000 as an independent risk factor for NCI in patients with SLE. Conclusion. We conclude that reduced psychomotor speed is an SLE-specific pattern of NCI. Verbal-memory deficits that have been reported in patients with SLE were not evident among patients who were corticosteroid-naive. Our results indicate that impaired psychomotor speed may be added to the symptoms of early SLE.

AB - Objective. Neurocognitive impairment (NCI) has been intensively studied in patients with systemic lupus erythematosus (SLE). However, those studies have mostly included patients who were treated with corticosteroids, which may itself induce NCI. We investigated NCI in corticosteroid-naive people with SLE who did not exhibit any overt neuropsychiatric manifestations. Methods. Forty-three inpatients with SLE who had no current or past neuropsychiatric history participated in the study. Patients and 30 healthy control subjects with similar demographic characteristics were given a 1-h battery of neuropsychological tests. NCI was defined as scores at least 2 SD below the mean of the healthy control group on at least 2 of the 7 neurocognitive domains. Results of clinical, laboratory, and neurologic tests were compared regarding the presence of NCI. Results. NCI was identified in 12 patients (27.9%) with SLE and in 2 control subjects (6.7%). Patients with SLE showed a significant impairment compared with controls on tasks assessing immediate recall, complex attention/executive function, and psychomotor speed. We identified psychomotor speed (Digit Symbol Substitution Test) as the factor that best differentiated the 2 groups. Further, we identified the score of the SLE Disease Activity Index 2000 as an independent risk factor for NCI in patients with SLE. Conclusion. We conclude that reduced psychomotor speed is an SLE-specific pattern of NCI. Verbal-memory deficits that have been reported in patients with SLE were not evident among patients who were corticosteroid-naive. Our results indicate that impaired psychomotor speed may be added to the symptoms of early SLE.

KW - Corticosteroids

KW - Neurocognitive impairment

KW - Systemic lupus erythematosus

UR - http://www.scopus.com/inward/record.url?scp=84923927466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923927466&partnerID=8YFLogxK

U2 - 10.3899/jrheum.140659

DO - 10.3899/jrheum.140659

M3 - Article

VL - 42

SP - 441

EP - 448

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 3

ER -