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Cognitive Impairment in Patients With Neuropsychiatric and Non-neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  19 March 2018

Arantzazu Zabala ,
Monika Salgueiro ,
Oihane Sáez-Atxukarro ,
Javier Ballesteros ,
Guillermo Ruiz-Irastorza  and
Rafael Segarra
Arantzazu Zabala*
Affiliation:
Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health System, BioCruces Health Research Institute, Barakaldo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
Monika Salgueiro
Affiliation:
Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health System, BioCruces Health Research Institute, Barakaldo, Spain
Oihane Sáez-Atxukarro
Affiliation:
Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
Javier Ballesteros
Affiliation:
Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
Guillermo Ruiz-Irastorza
Affiliation:
Autoimmune Diseases Research Unit. Department of Internal Medicine, Cruces University Hospital, Osakidetza-Basque Health System, BioCruces Health Research Institute, Barakaldo, Spain
Rafael Segarra
Affiliation:
Department of Neurosciences, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health System, BioCruces Health Research Institute, Barakaldo, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
*
Correspondence and reprint requests to: Arantzazu Zabala, Department of Neuroscience-Psychiatry. Faculty of Medicine and Nursing, University of the Basque Country, Barrio Sarriena s/n, 48940 Leioa, Bizkaia, Spain. E-mail: arantzazu.zabala@ehu.eus
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Abstract

Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Its most prevalent manifestation is neuropsychiatric SLE (NP-SLE), which is characterized by increased involvement of the nervous system, with relevant symptoms, such as marked cognitive deficits, which are directly involved in subsequent functional disability. The objective of this study is to identify and compare the profile of cognitive deficits in patients with NP-SLE and patients with non-neuropsychiatric SLE (nonNP-SLE) by means of a systematic review and meta-analysis. Methods: We performed a systematic literature search based on the key words “cogn* OR neurocogn* AND lupus AND neuropsychiatry*” and included articles published between April 1999 and December 2016. A total of 244 articles were retrieved. We excluded reviews and meta-analyses, experiments not performed in humans, and single case reports. We included studies that used standardized cognitive measures and had included at least the subgroups NP-SLE and non NP-SLE. Results: The meta-analysis was finally based on six studies, and 10 neuropsychological variables were examined. Significant differences were observed between the groups for six variables. In the remaining four variables, we observed marked heterogeneity between the groups or a low number of studies. Conclusions: The data obtained indicate greater cognitive impairment among NP-SLE patients than among nonNP-SLE patients, at least for the cognitive domains of visuomotor coordination, attention, executive function, visual learning and memory, and phonetic fluency. The identification and definition of cognitive deficits in SLE patients is necessary to develop adequate cognitive remediation programs to improve functional outcomes. (JINS, 2018, 24, 629–639)

Keywords

Systemic lupus erythematosusNeuropsychiatric systemic lupus erythematosusCognitive impairmentNeuropsychologyReviewMeta-analysis
Type
Critical Review
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 6 , July 2018 , pp. 629 - 639
Copyright
Copyright © The International Neuropsychological Society 2018 

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