Cognitive Dysfunction in Neuropsychiatric Systemic Lupus Erythematosus

Melanie J. Harrison, MD, MS, Lisa D. Ravdin, PhD

Disclosures

Curr Opin Rheumatol. 2002;14(5) 

In This Article

New Imaging Techniques

Two investigations applied novel imaging techniques to detect abnormalities that might be associated with cognitive dysfunction. Weiner et al.[27] evaluated 23 SLE patients with neuropsychiatric disease, five SLE patients without neuropsychiatric disease, and ten healthy controls using F-18 fluorodeoxyglucose PET scanning. Particular tests of cognitive function were not mentioned, however, several patients were noted to have impairment of attention, concentration, memory, or word finding. Although the results were not specific to cognitive dysfunction, almost all subjects with such difficulties had parieto-occipital hypoperfusion regardless of magnetic resonance imaging (MRI) findings. All SLE patients who had cognitive dysfunction and no other neuropsychiatric disease had normal MRIs. A second study[28] evaluated cognitive function as it related to reduced regional cerebral blood flow measured by 99mTC-HMPAO-SPECT. Both global and regional perfusion abnormalities were identified; hypoperfusion was most often identified in the frontal, temporal, and parietal regions. Slow psychomotor speed was associated with decreased regional cerebral blood flow in the parietal lobe, and executive dysfunction with the frontal lobe. Cognitive dysfunction was associated with cerebral infarcts identified by MRI, but not by decreases in regional cerebral blood flow. Thus, SPECT did not appear to add significant information to methods already used in routine evaluation of cognitive dysfunction in SLE.

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