Hanan Al Rayes1, Chiara Tani2, Andrew Kwan3, Sherief Marzouk4, Kenneth Colosimo5, Jorge Medina-Rosas6, Ahmed Mustafa5, Jiandong Su5, Panos Lambiris7, Marta Mosca2, Zahi Touma8. 1. Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Lupus Clinic, EW, 1-412, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada; Consultant Rheumatology, Prince Sultan Military Medical City, Department of Medicine, Riyadh, Saudi Arabia. 2. University of Pisa, Pisa, Italy. 3. Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Lupus Clinic, EW, 1-412, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada; Queen's University, Kingston, Ontario, Canada. 4. Faculty of Medicine, Department of Psychiatry, Neuropsychiatry Division, University of Toronto, Toronto, Ontario, Canada. 5. University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada. 6. Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Lupus Clinic, EW, 1-412, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. 7. Library and Information Services, University of Toronto, Toronto, Ontario, Canada. 8. Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Lupus Clinic, EW, 1-412, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: zahi.touma@uhn.ca.
Abstract
OBJECTIVES: To systematically review the literature on the prevalence of Cognitive Dysfunction (CD) in SLE patients in studies that used a specified neuropsychological instrument. METHODS: This review was prepared with a protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols statement. Literature search in Ovid Medline, Embase, and Psyc INFO for articles on CD in adult SLE patients was conducted. Included studies were critically appraised (Newcastle-Ottawa Evaluation Scale) and the Pooled Prevalence (PP) of CD was studied for all instruments. The association between demographics and CD, the risk of CD in SLE compared to healthy subjects and patients with RA, and the course of CD over time were studied narratively whenever sufficient information was available. RESULT: Of 8054 references, 670 were selected for detailed review and 78 were included in the final analysis. Comprehensive Battery (CB) was utilized in 35 studies in 2463 SLE patients and PP was 38% (95%; CI: 33-43%). The CD prevalence was higher in NPSLE [PP 39% (95% CI: 24-55%]. Automated Neuropsychological Assessment Metric (ANAM) was utilized in 7 studies in 438 patients (PP of CD 26% (95% CI: 12-42%). Other less frequently utilized tools were the Modified Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Controlled Oral Word Association Test (COWAT) and The Hopkins Verbal Learning Test-Revised (HVLT-R) and subjective tools and others. The relative risk for CD in SLE was greater when compared to RA and to healthy individuals; RR being 1.80 and 2.80, respectively. Information on demographics and its association with CD was very heterogeneous among studies. CONCLUSION: Patients with lupus have a high prevalence of CD. The delay in diagnosis of CD is complex; although caregivers and patients express concerns about cognitive function, testing for CD often imposes administrative and cost burdens. There is an unmet need to identify the best screening, diagnostic metrics of CD. The assessment of cognitive function over time, and the association of demographics with CD, will require further research.
OBJECTIVES: To systematically review the literature on the prevalence of Cognitive Dysfunction (CD) in SLEpatients in studies that used a specified neuropsychological instrument. METHODS: This review was prepared with a protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols statement. Literature search in Ovid Medline, Embase, and Psyc INFO for articles on CD in adult SLEpatients was conducted. Included studies were critically appraised (Newcastle-Ottawa Evaluation Scale) and the Pooled Prevalence (PP) of CD was studied for all instruments. The association between demographics and CD, the risk of CD in SLE compared to healthy subjects and patients with RA, and the course of CD over time were studied narratively whenever sufficient information was available. RESULT: Of 8054 references, 670 were selected for detailed review and 78 were included in the final analysis. Comprehensive Battery (CB) was utilized in 35 studies in 2463 SLEpatients and PP was 38% (95%; CI: 33-43%). The CD prevalence was higher in NPSLE [PP 39% (95% CI: 24-55%]. Automated Neuropsychological Assessment Metric (ANAM) was utilized in 7 studies in 438 patients (PP of CD 26% (95% CI: 12-42%). Other less frequently utilized tools were the Modified Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Controlled Oral Word Association Test (COWAT) and The Hopkins Verbal Learning Test-Revised (HVLT-R) and subjective tools and others. The relative risk for CD in SLE was greater when compared to RA and to healthy individuals; RR being 1.80 and 2.80, respectively. Information on demographics and its association with CD was very heterogeneous among studies. CONCLUSION:Patients with lupus have a high prevalence of CD. The delay in diagnosis of CD is complex; although caregivers and patients express concerns about cognitive function, testing for CD often imposes administrative and cost burdens. There is an unmet need to identify the best screening, diagnostic metrics of CD. The assessment of cognitive function over time, and the association of demographics with CD, will require further research.
Authors: Meggan Mackay; An Vo; Chris C Tang; Michael Small; Erik W Anderson; Elisabeth J Ploran; Justin Storbeck; Brittany Bascetta; Simran Kang; Cynthia Aranow; Carl Sartori; Philip Watson; Bruce T Volpe; Betty Diamond; David Eidelberg Journal: JCI Insight Date: 2019-01-10
Authors: J M Chi; M Mackay; A Hoang; K Cheng; C Aranow; J Ivanidze; B Volpe; B Diamond; P C Sanelli Journal: AJNR Am J Neuroradiol Date: 2019-02-21 Impact factor: 3.825
Authors: John G Hanly; Alexandra Legge; Lyna Kamintsky; Alon Friedman; Javeria A Hashmi; Steven D Beyea; John Fisk; Antonina Omisade; Cynthia Calkin; Tim Bardouille; Chris Bowen; Kara Matheson; Marvin J Fritzler Journal: Lupus Sci Med Date: 2022-06
Authors: Elisabeth Ploran; Chris Tang; Meggan Mackay; Michael Small; Erik Anderson; Justin Storbeck; Brittany Bascetta; Simran Kang; Cynthia Aranow; Carl Sartori; Philip Watson; Bruce Volpe; Betty Diamond; David Eidelberg Journal: Lupus Sci Med Date: 2019-07-11