系统性红斑狼疮患者的认知表现：一项横断面和纵向研究。

Cognitive performance in systemic lupus erythematosus patients: a cross-sectional and longitudinal study.

作者信息

Langensee L, Mårtensson J, Jönsen A, Zervides K, Bengtsson A, Nystedt J, Cannerfelt B, Nilsson P, Mannfolk P, Lätt J, Rumetshofer T, Sundgren P C

机构信息

Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Faculty of Medicine, Lund University, 22185, Lund, Sweden.

Department of Clinical Sciences Lund, Rheumatology, Faculty of Medicine, Lund University, 22185, Lund, Sweden.

出版信息

BMC Rheumatol. 2022 Apr 20;6(1):22. doi: 10.1186/s41927-022-00253-3.

DOI:10.1186/s41927-022-00253-3

PMID:35440096

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9019974/

Abstract

BACKGROUND

Previous research has provided evidence for cognitive dysfunction as a common symptom of systemic lupus erythematosus (SLE). In light of this, the primary goal of this study was to investigate how cognitive impairment in this patient group develops over time. In addition, the present dataset contributes to delineating the specific abilities that are impaired in SLE patients as well as answering the question whether the disease affects the cognition of SLE patients with neuropsychiatric manifestations (NPSLE) and without (non-NPSLE) in distinct ways.

METHODS

91 female participants (33 NPSLE, 29 non-NPSLE, 29 healthy controls (HC)) underwent standardized neurocognitive testing. A total of ten different cognitive abilities were assessed, among others executive function, memory, and attention. Some of the participants (30 NPSLE patients, 22 non-NPSLE, 13 HC) were tested twice (mean time between testing sessions: 50 months) to enable longitudinal tracking of cognitive abilities. Analyses of Variance (ANOVA) were conducted to determine whether cognitive performance differed cross-sectionally between the groups. Linear mixed effects models were fit to investigate performance differences between the groups over time.

RESULTS

Cross-sectional analysis at follow-up demonstrated that the cognitive performance of both NPSLE and non-NPSLE was significantly lower than that of HC for the motor speed and the psychomotor speed domain. Additionally, NPSLE patients performed significantly weaker than HC in the complex attention domain. At the same time, the cross-sectional data did not yield any support for performance differences between NPSLE and non-NPSLE patients. Weak positive correlations between disease duration and psychomotor speed, motor speed and reaction time emerged. A temporal progression of cognitive dysfunction in SLE patients was not confirmed.

CONCLUSIONS

Cognitive performance is affected in both non-NPSLE and NPSLE patients. However, a linear decline in performance over time could not be verified. More in-depth longitudinal assessments of cognition in SLE patients are needed to establish how cognitive abilities in this patient population develop over time.

摘要

背景

先前的研究已证实认知功能障碍是系统性红斑狼疮（SLE）的常见症状。鉴于此，本研究的主要目的是调查该患者群体的认知障碍如何随时间发展。此外，当前数据集有助于描绘SLE患者受损的具体能力，以及回答该疾病是否以不同方式影响有神经精神表现（NPSLE）和无神经精神表现（非NPSLE）的SLE患者的认知这一问题。

方法

91名女性参与者（33名NPSLE患者、29名非NPSLE患者、29名健康对照者（HC））接受了标准化神经认知测试。总共评估了十种不同的认知能力，包括执行功能、记忆和注意力等。部分参与者（30名NPSLE患者、22名非NPSLE患者、13名HC）接受了两次测试（测试之间的平均时间间隔：50个月），以便对认知能力进行纵向跟踪。进行方差分析（ANOVA）以确定各组之间的认知表现是否存在横断面差异。采用线性混合效应模型来研究各组随时间的表现差异。

结果

随访时的横断面分析表明，在运动速度和精神运动速度领域，NPSLE和非NPSLE患者的认知表现均显著低于HC。此外，NPSLE患者在复杂注意力领域的表现明显弱于HC。同时，横断面数据未显示NPSLE和非NPSLE患者之间存在表现差异。疾病持续时间与精神运动速度、运动速度和反应时间之间出现了弱正相关。未证实SLE患者认知功能障碍存在时间上的进展。