Prevalence, involved domains, and predictor of cognitive dysfunction in systemic lupus erythematosus.

Background: Cognitive Dysfunction (CD) can occur in Systemic Lupus Erythematosus (SLE) before the occurrence of Neuropsychiatric Lupus Erythematosus (NPSLE). Given the reversibility and fluctuation of SLE-related CD, the research for possible predictors is of great significance for early detection and intervention.

Objective: We sought to determine the prevalence, involved domains, and possible predictors of CD in SLE patients.

Methods: We conducted a retrospective cross-sectional study at Nanfang Hospital from 2018 to 2019. A total of 78 SLE patients were recruited. The Montreal Cognitive Assessment (MoCA) scale was used to screen cognitive function. Demographic, clinical, and laboratory characteristics were collected. The serum anti-methyl-d-aspartate receptor (anti-NMDAR) antibody and S100β were measured by enzyme-linked immunosorbent assay (ELISA). Multivariate logistic regression analysis and ROC curve were used to assess the predictor of SLE-related CD.

Results: Of 78 recruited patients,53 (67.9%) had CD. It mainly involved delayed recall, abstract generalization, verbal repetition, and fluency. The disease activity index (SLEDAI) was not associated with SLE-related CD ( > 0.05). Multivariate logistic regression showed that an increase in each year of education there was a decrease in the likelihood of CD (OR 0.261, CI 0.080-0.857,  = 0.027) whereas with each unit increase in serum anti-NMDAR antibody there was an increased likelihood of SLE-related CD (OR 1.568, CI 1.073-2.292,  = 0.020).

Conclusion: The prevalence of SLE-related CD was 67.9% in our study and SLE-related CD was not associated with disease activity. Serum anti-NMDAR antibody can be used as a predictor for SLE-related CD.