Subtle brain deficits seen in lupus patients

By Nancy Ehrlich Lapid

NEW YORK (Reuters Health) - Psychiatric and neurologic disorders are common in patients with lupus, and new research confirms that problems with attention, memory, and reasoning are present even in lupus patients without overt brain manifestations of the disease.

Lupus, technically known as systemic lupus erythematosus or SLE, is a chronic “autoimmune” disease in which the immune system can confuse healthy and foreign tissues and sometimes attacks both. The condition can vary widely in severity, manifesting as skin rash and arthritis or leading to damage to the kidneys, heart, lungs and brain to varying degrees. There is no cure.

Dr. Elizabeth Kozora at the National Jewish Medical and Research Center in Denver and colleagues studied 67 SLE patients who were free of psychiatric and neurologic disorders and 29 healthy controls.

There were no differences in “global” brain functioning between the SLE patients and the controls. However, tests did show that SLE patients had impairments in attention, memory, and reasoning, suggesting silent or “subclinical” involvement of the brain.

The SLE patients had “significantly higher rates” of impairment on logical reasoning and verbal memory and trends toward greater impairment on visual attention and working memory, compared with the controls.

The researchers also found that the SLE patients scored higher on measures of depression and perceived brain difficulties, compared with controls.

Kozora’s group concludes that SLE patients without apparent neurologic or psychiatric disorders have specific declines “in the areas of attention, memory, and reasoning,” and they call for continued study into subtle brain involvement in lupus patients.

SOURCE: Arthritis and Rheumatism, December 2008.

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