剑桥神经心理测试自动成套测验在评估系统性红斑狼疮患者认知参数与自身抗体谱的关系中的应用

Cambridge Neuropsychological Test Automated Battery in assessment of cognitive parameters in patients with systemic lupus erythematosus in relation to autoantibody profile.

作者信息

Bogaczewicz Anna, Sobow Tomasz, Kowalski Jan, Ząbek Jakub, Woźniacka Anna, Bogaczewicz Jaroslaw

机构信息

Department of Medical Psychology, Medical University of Lodz, Poland.

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland.

出版信息

Reumatologia. 2015;53(3):131-8. doi: 10.5114/reum.2015.53134. Epub 2015 Aug 7.

DOI:10.5114/reum.2015.53134

PMID:27407239

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4847298/

Abstract

OBJECTIVES

To relate the cognitive parameters of systemic lupus erythematosus (SLE) patients in remission to their profile of autoantibodies.

MATERIAL AND METHODS

The study included 32 patients with SLE in remission, with mild disease activity as indicated by SELENA-SLEDAI < 6. For neuropsychological assessment, the Cambridge Neuropsychological Test Automated Battery (CANTAB) was applied, using motor screening (MOT), big little circle (BLC), paired associated learning (PAL), stockings of Cambridge (SOC), and graded naming tests (GNT). Detection of autoantibodies against dsDNA, nucleosome (aNuc), Sm, and anticardiolipin (aCL: IgG and IgM) was performed with immunoassays.

RESULTS

The SLE patients demonstrated standard scores below norms, matched according to age and gender, in the following tests: GNT (-0.87 ±0.85), SOC PSMM (-0.47 ±0.97), PAL (-1.88 ±3.58), and BLC (-0.31 ±1.90). GNT scores under -0.5 were found significantly more frequently in SLE patients, seen in roughly 66% of test subjects. Values for PAL and mean subsequent thinking time of stockings of Cambridge (SOC MSTT) were found to be lower than -0.5 in approximately half of the patients. Mean error of motor screening (MOT ME) was found to negatively correlate with mean latency of motor screening (MOT ML) (r = -0.55). PAL significantly correlated with SOC MSTT (r = 0.38) and with GNT (r = 0.36). Anti-dsDNA antibody level correlated negatively with MOT ME (r = -0.46). Anti-Nuc antibodies correlated with MOT ML (r = 0.41) but negatively correlated with MOT ME (r = -0.58). The levels of anti-Sm, anti-CL IgM and IgG did not correlate significantly with the outcomes of CANTAB. The age of the patients correlated negatively with MOT ME (r = -0.36), positively with BLC (r = 0.53) and negatively with SOC MSTT (r = -0.43). The level of anti-Nuc antibodies correlated with anti-dsDNA level (r = 0.62) and of anti-CL IgM with anti-Sm (r = 0.39) and anti-CL IgG (r = 0.87).

CONCLUSIONS

CANTAB reveals a decrease in selected cognitive functions in patients with SLE. ACL IgG and anti-dsDNA antibodies indicated SLE patients prone to develop a decrease in cognitive functions.

摘要

目的

探讨缓解期系统性红斑狼疮（SLE）患者的认知参数与其自身抗体谱之间的关系。

材料与方法

本研究纳入32例缓解期SLE患者，疾病活动度较轻，SELENA-SLEDAI评分<6。采用剑桥神经心理测试自动成套系统（CANTAB）进行神经心理学评估，包括运动筛查（MOT）、大小圆圈测试（BLC）、配对联想学习测试（PAL）、剑桥长袜测试（SOC）和分级命名测试（GNT）。采用免疫分析法检测抗双链DNA（dsDNA）、核小体（aNuc）、Sm和抗心磷脂（aCL：IgG和IgM）自身抗体。

结果

SLE患者在以下测试中的标准分数低于根据年龄和性别匹配的正常范围：GNT（-0.87±0.85）、SOC PSMM（-0.47±0.97）、PAL（-1.88±3.58）和BLC（-0.31±1.90）。GNT分数低于-0.5在SLE患者中更为常见，约66%的受试者出现这种情况。约一半患者的PAL值和剑桥长袜测试的平均后续思考时间（SOC MSTT）低于-0.5。发现运动筛查平均误差（MOT ME）与运动筛查平均潜伏期（MOT ML）呈负相关（r=-0.55）。PAL与SOC MSTT（r=0.38）和GNT（r=0.36）显著相关。抗dsDNA抗体水平与MOT ME呈负相关（r=-0.46）。抗核小体抗体与MOT ML相关（r=0.41），但与MOT ME呈负相关（r=-0.58）。抗Sm、抗CL IgM和IgG水平与CANTAB结果无显著相关性。患者年龄与MOT ME呈负相关（r=-0.36），与BLC呈正相关（r=0.53），与SOC MSTT呈负相关（r=-0.43）。抗核小体抗体水平与抗dsDNA水平相关（r=0.62），抗CL IgM与抗Sm相关（r=0.39），与抗CL IgG相关（r=0.87）。