Evaluation of predictive factors for neurocognitive dysfunction in patients with inactive systemic lupus erythematosus

Objective. To determine predictive factors associated with the cognitive dy sfunction in patients with inactive systemic lupus crythematosus (SLE). Methods. Consecutive patients followed at the Lupus Clinic with inactive SL E (SLE Disease Activity Index, SLEDAI, = 0) underwent a battery of neuropsy chological tests; Beck Depression Inventory and psychiatric assessment were also performed. Neurocognitive dysfunction was defined as 3 abnormal score s. Data were analyzed using chi-square tests, ANOVA tests, and logistic reg ression. Results. Twenty-five of the 58 patients with SLE (43%) versus 9 of 47 healt hy controls (19%) demonstrated neurocognitive dysfunction (p < 0.01). Neuro cognitive dysfunction was not associated with depression or a psychiatric d iagnosis, use of steroids, or previous or current evidence for fibromyalgia . SLEDAI > 10 at first presentation to the Lupus Clinic and previous vascul itis were associated with neurocognitive dysfunction, but previous central nervous system disease, renal disease, renal damage, or atherosclerotic com plications were not. Neurophysiologic studies at the time of the assessment were not predictive of neurocognitive dysfunction. Conclusion. Patients with inactive SLE demonstrate neurocognitive dysfuncti on. This is associated with more disease activity at presentation, but is n ot associated with specific organ involvement or organ damage.