Abnormalities of inflammatory and hormonal measures are common
in SLE patients. Although cognitive dysfunction has been documented
in SLE patients, the biological mechanism of these deficits
has not been clarified. The goal of this study was to explore
the relationship between inflammatory and hormonal activity
and measures of learning, fluency, and attention in systemic
lupus erythematosus patients without neuropsychiatric symptoms
(non-CNS–SLE), patients with rheumatoid arthritis (RA),
and healthy controls (HC). Fifteen non-CNS–SLE patients,
15 RA patients and 15 HC participants similar in age, education,
and gender (female) were compared on tests of cognition,
depression, and plasma levels of interleukin-6 (IL-6),
dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate
(DHEA-S) and cortisol. Non-CNS–SLE patients demonstrated
lower learning and poorer attention. Furthermore, non-CNS–SLE
and RA patients had significantly lower levels of DHEA and DHEA-S
than HC participants. Hierarchical regression analysis demonstrates
that DHEA-S and IL-6 accounts for a unique portion of the variance
in subject performance on measures of learning and attention
after controlling for depression and corticosteroid treatment.
This data highlights the value of hierarchical analyses with
covariates, and provides evidence in humans of a relationship
between peripheral cytokine levels and cognitive function.
(JINS, 2001, 7, 745–754.)
Development of systemic lupus erythematosus in a patient with congenital heart block
