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RESEARCH - Cognitive deficits in patients with APS: association with clinical, laboratory, and brain MRI findings

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Cognitive deficits in patients with antiphospholipid syndrome: association

with clinical, laboratory, and brain magnetic resonance imaging findings.

Arch Intern Med. 2006 Nov 13;166(20):2278-84.

Department of Pathophysiology, School of Medicine, National University of

Athens, Euroclinic Hospital, Athens, Greece. balts@...

BACKGROUND: Antiphospholipid syndrome (APS) is a multisystem disorder

characterized by arterial and venous thromboses, pregnancy morbidity, and

various neuropsychiatric manifestations. Cognitive dysfunction in APS has

been poorly recognized. We examined for the first time, to our knowledge,

the presence of cognitive dysfunction in patients with APS and its

association with clinical, laboratory, and cerebral magnetic resonance

imaging characteristics. METHODS: Sixty patients (39 with primary APS and 21

with systemic lupus erythematosus-related APS) and 60 healthy individuals

matched for age, sex, and education were examined by means of a

comprehensive 3-hour battery of neuropsychological tests. Twenty-three

patients had a history of central nervous system involvement. Fifty-nine of

60 patients underwent brain magnetic resonance imaging at the time of

neuropsychological assessment. A disease control group not fulfilling

criteria for APS (15 patients with systemic lupus erythematosus and 10 with

rheumatoid arthritis) was also included. The demographic, clinical, and

laboratory characteristics of patients were recorded. RESULTS: Twenty-five

(42%) of the 60 patients with APS had cognitive deficits compared with 11

(18%) healthy control subjects (P = .005). No patient was diagnosed as

having dementia. The most commonly involved cognitive domains were complex

attention and verbal fluency. No difference was found in cognitive

performance between patients with primary APS and those with systemic lupus

erythematosus-related APS. No relationship was detected between cognitive

dysfunction and prior central nervous system disease. We noted a significant

association between cognitive dysfunction and livedo reticularis (P = .004)

as well as between cognitive dysfunction and the presence of white matter

lesions on the findings of brain magnetic resonance imaging (P=.01). No

difference was detected in cognitive performance between the disease control

group and healthy individuals (P=.86).

CONCLUSIONS: Cognitive deficits may often be found among patients with APS,

independent of any history of central nervous system involvement. Livedo

reticularis and the presence of white matter lesions on brain magnetic

resonance imaging are associated with an increased risk for cognitive

dysfunction in APS.

PMID: 17101948

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17101948

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

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