Functional MRI of Working Memory and Executive Dysfunction in Systemic Lupus Erythematosus and Antiphospholipid Antibody Positive Patients.

Arthritis Care Res (Hoboken). 2016 Mar 4;

Authors: Kozora E, Uluğ AM, Erkan D, Vo A, Filley CM, Ramon G, Burleson A, Zimmerman R, Lockshin MD

Abstract
OBJECTIVE: Standardized cognitive tests and functional magnetic resonance imaging (fMRI) studies of SLE patients demonstrate deficits in working memory and executive function. These neurobehavioral abnormalities are not well studied in antiphospholipid syndrome (APS), which may occur independently of or together with SLE. This study compares an fMRI paradigm involving motor, working memory and executive function in SLE patients without antiphospholipid antibody (SLE), aPL-positive non-SLE patients (aPL+), and controls.
METHODS: Brain magnetic resonance imaging (MRI), functional MRI (fMRI) and standardized cognitive assessment were obtained on 20 SLE, 20 aPL+ and 10 healthy female subjects with no history of neuropsychiatric activity.
RESULTS: Analysis of fMRI data showed no differences in performance across groups on bilateral motor tasks. Significant group differences using ANOVA were found on two executive tasks (word generation and word rhyming) and in a working memory task (N-back). Patients positive for aPL demonstrated higher activation in bilateral frontal, temporal and parietal cortices compared to controls during tasks of working memory and executive function. SLE patients also demonstrated bilateral frontal and temporal activation during working memory and executive function tasks.
CONCLUSIONS: Compared to controls, both aPL+ and SLE patients had elevated cortical activation, primarily in the frontal lobes, during tasks of working memory and executive function. These findings are consistent with cortical over-activation as a compensatory mechanism for early white matter neuropathology in these disorders. This article is protected by copyright. All rights reserved.

PMID: 26946337 [PubMed - as supplied by publisher]