Features of Cognitive Dysfunction in Patients with Systemic Lupus Erythematosus

Abstract

The purpose of the study was to explore the structure of cognitive impairment in patients with systemic lupus erythematosus and to determine the factors associated with its development. Materials and methods. Advanced examination of 64 patients with systemic lupus erythematosus was carried out. Neurological disorders were diagnosed in 54 patients (84.38% of patients). These patients were included in the main study group (group 1). In 10 (15.62% of patients) patients, these manifestations were not found and they entered the control group (group 2). The object of the study was cognitive impairment in patients with systemic lupus erythematosus. To assess the cognitive status of patients, the Montreal Cognitive Assessment Scale was used, a widely used questionnaire that evaluates cognitive functions across multiple domains. The laboratory study included blood tests to identify the type and titer of antinuclear antibodies, lupus anticoagulant, and antiphospholipid antibodies, in particular, anti-cardiolipin antibodies. Results and discussion. It was found that the complaints that patients usually present to describe impaired cognitive functions (such as "memory deterioration", "memory impairment", "decreased attention", "difficulty concentrating", etc.) were among the most common in patients with systemic lupus erythematosus. Thus, complaints of memory impairments were expressed by 37 patients (57.81% CI 45.71-69.91), impaired attention and concentration – 41 patients (64.06% CI 52.31-75.82), and between these complaints a strong correlation was established (r = 0.83; p <0.001). The results of the examination of patients using the Montreal Cognitive Assessment Scale showed that the average indicator among all examined is 25.0 (22.0; 27.5) points in the main group – 24.0 (22.0; 26.0) points, which is statistically significantly less (p <0.001) compared with the control group – 28.0 (27.0; 29.0) points. It was found that among patients who scored less than 26 points on the Montreal Cognitive Assessment Scale, there was a statistically significant decrease in indicators in the domains of memory, attention, and speech (p <0.001). It was found that there is a correlation between the presence of anti-cardiolipin antibodies with CD (determined by the Montreal Cognitive Assessment Scale) (rs = -0.56; p <0.001), the same correlation was found in relation to lupus anticoagulant (rs = -0.56; p <0.001). Conclusion. Cognitive dysfunction is one of the most common neurological manifestations of systemic lupus erythematosus. Among the examined patients, decrease in indicators in the domains of memory, attention and speech is the most often observed. Cognitive dysfunction may be associated with the production of certain classes of autoantibodies: antiphospholipid antibodies (in particular, anti-cardiolipin antibodies) and lupus anticoagulant