Neuropsychiatric Lupus from Bench to Bedside

A special issue of Cells (ISSN 2073-4409).

Deadline for manuscript submissions: closed (10 December 2023) | Viewed by 3101

Special Issue Editor

Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
Interests: inflammation; innate immunity; autoimmunity; human immunology; autoimmune disorders; rheumatic diseases; adaptive immunity

Special Issue Information

Dear Colleagues,

Neuropsychiatric manifestations constitute typical, although often elusive, hallmarks of systemic lupus erythematosus (SLE). Despite significant achievements in the definition of pragmatic algorithms for the attribution of major neuropsychiatric events to SLE and constant technical improvements in the accuracy and informativeness of imaging and laboratory diagnostic tools, the borders of neurological morbidity in SLE are still ill-defined, and neuropsychiatric SLE (NPSLE) management remains challenging. There is also limited knowledge about the pathophysiological events supporting the onset and persistence of neuropsychiatric manifestations in SLE. This Special Issue aims to collect novel evidence, perspectives, and/or comprehensive reviews of existing data on innovations in the field of NPSLE pathophysiology, diagnostics, and treatment. By doing so, this project also aims to promote the integration of multidisciplinary expertise, possibly contributing to accelerating the development of novel strategies for patient monitoring and treatment.

Dr. Giuseppe A. Ramirez
Guest Editor

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Keywords

  • neuropsychiatric lupus
  • neuropsychiatric manifestations
  • neurolupus
  • NPSLE
  • systemic lupus erythematosus
  • magnetic resonance imaging
  • autoantibodies
  • cognitive impairment
  • psychosis
  • stroke
  • epilepsy
  • neurological morbidity

Published Papers (2 papers)

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Research

13 pages, 997 KiB  
Article
Microstructural Changes in the Corpus Callosum in Systemic Lupus Erythematous
Cells 2023, 12(3), 355; https://doi.org/10.3390/cells12030355 - 18 Jan 2023
Cited by 1 | Viewed by 1455
Abstract
Central nervous system (CNS) involvement in childhood-onset systemic lupus erythematosus (cSLE) occurs in more than 50% of patients. Structural magnetic resonance imaging (MRI) has identified global cerebral atrophy, as well as the involvement of the corpus callosum and hippocampus, which is associated with [...] Read more.
Central nervous system (CNS) involvement in childhood-onset systemic lupus erythematosus (cSLE) occurs in more than 50% of patients. Structural magnetic resonance imaging (MRI) has identified global cerebral atrophy, as well as the involvement of the corpus callosum and hippocampus, which is associated with cognitive impairment. In this cross-sectional study we included 71 cSLE (mean age 24.7 years (SD 4.6) patients and a disease duration of 11.8 years (SD 4.8) and two control groups: (1) 49 adult-onset SLE (aSLE) patients (mean age of 33.2 (SD 3.7) with a similar disease duration and (2) 58 healthy control patients (mean age of 29.9 years (DP 4.1)) of a similar age. All of the individuals were evaluated on the day of the MRI scan (Phillips 3T scanner). We reviewed medical charts to obtain the clinical and immunological features and treatment history of the SLE patients. Segmentation of the corpus callosum was performed through an automated segmentation method. Patients with cSLE had a similar mid-sagittal area of the corpus callosum in comparison to the aSLE patients. When compared to the control groups, cSLE and aSLE had a significant reduction in the mid-sagittal area in the posterior region of the corpus callosum. We observed significantly lower FA values and significantly higher MD, RD, and AD values in the total area of the corpus callosum and in the parcels B, C, D, and E in cSLE patients when compared to the aSLE patients. Low complement, the presence of anticardiolipin antibodies, and cognitive impairment were associated with microstructural changes. In conclusion, we observed greater microstructural changes in the corpus callosum in adults with cSLE when compared to those with aSLE. Longitudinal studies are necessary to follow these changes, however they may explain the worse cognitive function and disability observed in adults with cSLE when compared to aSLE. Full article
(This article belongs to the Special Issue Neuropsychiatric Lupus from Bench to Bedside)
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11 pages, 305 KiB  
Article
Cognitive Performance in Patients with Systemic Lupus Erythematosus Using the Ped-ANAM
Cells 2022, 11(24), 4054; https://doi.org/10.3390/cells11244054 - 15 Dec 2022
Cited by 2 | Viewed by 1319
Abstract
Computerized batteries have been widely used to investigate cognitive impairment (CI) in patients with SLE. The aim of this study was to evaluate the cognitive performance of patients with SLE in relation to healthy controls using the Pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) [...] Read more.
Computerized batteries have been widely used to investigate cognitive impairment (CI) in patients with SLE. The aim of this study was to evaluate the cognitive performance of patients with SLE in relation to healthy controls using the Pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) battery. In addition, we aimed to examine differences in Ped-ANAM scores according to age of disease onset, presence of disease activity, and disease damage. We included 201 consecutive adult-onset (aSLE) and childhood-onset SLE (cSLE) patients who were being followed at the hospital’s rheumatology outpatient clinic and 177 healthy controls. We applied the percentage of correct answers on the Ped-ANAM subtests and the Performance Validity Index (PVI) metric and correlated them with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus Erythematosus Damage Index (SDI). Then, we established their relationships with neuropsychiatric systemic lupus erythematosus (NPSLE). We observed CI in a total of 38 (18.9%) SLE patients and 8 (4.5%) healthy controls (p < 0.001). CI was observed in eight (19.5%) cSLE patients and 32 (20%) aSLE patients (p = 0.8175). Individual analysis of the aSLE subtests showed a significant difference in all subtests compared to healthy controls; the greatest differences were in matching to sample (p < 0.001) and memory search ( p < 0.001). In the cSLE group, we observed a difference in the code substitution subtests (p = 0.0065) compared to the healthy controls. In the evaluation of clinical outcomes, disease activity was significantly correlated with CI in cSLE (r = 0.33; p = 0.042) and aSLE (r = 0.40; p = 0.001). We also observed an association between disease activity and neuropsychiatric manifestations (p = 0.0012) in aSLE. In conclusion, we determined that cognitive dysfunction, mainly in memory and attention, was more prevalent in patients with SLE. In both the cSLE and aSLE groups, disease activity was associated with worse cognitive function. This is the first study to use the Ped-ANAM in Brazil. Longitudinal studies are necessary to determine how the Ped-ANAM will perform over time. Full article
(This article belongs to the Special Issue Neuropsychiatric Lupus from Bench to Bedside)
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