RESEARCH - Neuropsychiatric syndromes in patients with SLE and primary Sjogren's syndrome

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Ann Rheum Dis. Published Online First: 17 October 2008.

doi:10.1136/ard.2008.098301

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Extended Report

Neuropsychiatric syndromes in patients with Systemic Lupus

Erythematosus and primary Sjögren's Syndrome – A comparative

population-based study

Erna Harboe 1*, Anne Bolette Tjensvoll 1, Stian Maroni 1, Lasse Gunnar

Gøransson 1, Ole Jakob Greve 1, Mona Kristiansen Beyer 1, Anita

Herigstad 2, Jan Terje Kvaløy 2 and Roald Omdal 3

1 Stavanger University Hospital, Norway

2 University of Stavanger, Norway

3 University of Bergen, Norway

Abstract

Objectives: To compare the prevalence and pattern of neuropsychiatric

(NP) syndromes observed in systemic lupus erythematosus (SLE) to

patients with Primary Sjögren's syndrome (PSS) using the American

College of Rheumatology (ACR) criteria for the nineteen NP syndromes

seen in SLE.

Methods: Population-based study including 68 patients with SLE (age

43.8 ± 13.6 years) and 72 with PSS (age 57.8 ± 13.0 years).

Specialists in internal medicine, neurology, and neuropsychology

performed standardized examinations. Cerebral MRI-scans and

neurophysiological studies were performed in all patients.

Results: Similar prevalences in SLE and PSS were observed for

headaches (87% vs 78%, p = 0.165), cognitive dysfunction (46% vs 50%,

p = 0.273), mood disorders (26% vs 33%, p = 0.376), anxiety disorders

(12% vs 4%, p = 0.095), cranial neuropathy (1% vs 4%, p = 0.339), and

seizure disorders (7% vs 3%, p = 0.208) . Cerebrovascular disease was

more common in SLE than PSS (12% vs 3%, p = 0.049); but mononeuropathy

(0% vs 8%, p = 0.015) and polyneuropathy (18% vs 56%, p < 0.0001) were

less common in SLE than PSS. Other syndromes were rare or absent in

both patient groups.

Conclusions: Headache, cognitive dysfunction, and mood disorders are

common in both diseases, but otherwise there are distinct differences

in NP involvement with cerebrovascular disease more prevalent in SLE,

and neuropathies more common in PSS. This indicates that some NP

disease mechanisms are shared and others differ between the two

diseases.

http://ard.bmj.com/cgi/content/abstract/ard.2008.098301v1?papetoc

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