ANALYSIS OF COGNITIVE AND PSYCHOLOGICAL DEFICITS IN SYSTEMIC LUPUS-ERYTHEMATOSUS PATIENTS WITHOUT OVERT CENTRAL-NERVOUS-SYSTEM DISEASE

Objective. To examine cognitive and psychological functioning in relat ion to antiribosomal P protein autoantibodies in patients with systemi c lupus erythematosus (SLE) who had no previous history of central ner vous system disease (non-CNS SLE). Methods. Comprehensive neuropsychol ogical and psychological tests were administered to 51 non-CNS SLE pat ients, 29 rheumatoid arthritis (RA) patients, and 27 healthy controls. Results. Twenty-nine percent of the non-CNS SLE patients, 31% of the RA patients, and 11% of the control subjects were classified as cognit ively impaired, Similar reductions in intelligence, attention, and flu ency were detected in the non-CNS SLE and RA patients compared with co ntrols, The non-CNS SLE patients showed a distinct deficit in learning compared with the RA and control groups, Forty-two percent of the non -CNS SLE patients demonstrated psychological distress, compared with 7 % of the RA patients and 6% of the controls, In the patient groups, ne ither cognitive dysfunction nor psychological distress,vas associated with disease activity or prednisone dosage, Elevated serum levels of a utoantibodies to ribosomal P protein were not associated with either p sychological or cognitive abnormalities. Conclusion. These results sug gest that certain cognitive deficits in non-CNS SLE patients may not b e specific to the immunopathology of SLE, In contrast, it is possible that deficits in learning, as well as psychological distress without m ajor psychiatric pathology, may be subtle manifestations of CNS lupus.