Cognitive Issues

The focus on cognitive sequelae in SLE is due to central nervous system (CNS) involvement inherent to the disease. SLE may affect many organs in the body including the brain. A slow decline in cognitive functions is frequently common among individuals with SLE, and it has been estimated that up to 60% of lupus patients experience gradual declines in cognitive functions (Takada 2008). Harrison and Ravdin (2002) observed that prevalence of cognitive impairments among individuals with SLE is quite variable given the diversity of demographics and disease presentation. Those cognitive functions that have been found to be impaired include short- and long-term memory, speed of information processing, ability to relate objects in space and time, and processing of emotions (for a review, see Takada 2008). Impairment may progress over the course of time and have significant impact on school or occupational functioning. Specific mechanisms underlying cognitive impairments in these individuals include occlusion of the blood vessels due to inflammation of blood vessels in the brain (vasculitis), effects of medication such as prednisone, and specific antibodies in the brain that impair cognitive functioning. Finally, there has been some evidence to suggest that single photon emission computed tomography (SPECT) may be a viable biological marker representing cerebral involvement of cognitive impairments among individuals with SLE (Kodama et al. 1995).

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