White matter abnormalities and working memory impairment in systemic lupus erythematosus.
White matter abnormalities and working memory impairment in systemic lupus erythematosus.
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DOI：
10.1097/wnn.0b013e31829d5c74
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发表时间：
2013-06
期刊：
影响因子：
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通讯作者：
Filley CM
中科院分区：
文献类型：
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作者：
Kozora E;Arciniegas DB;Duggan E;West S;Brown MS;Filley CM
许多系统性红斑狼疮（SLE）患者存在工作记忆缺陷。很少有研究使用磁共振波谱（MRS）评价SLE患者的工作记忆表现和神经代谢产物。我们对73名系统性红斑狼疮患者进行了节奏听觉连续加法测试（PASAT），这是一种工作记忆的测量方法。我们计算了总分、二分、组块和认知疲劳。使用MRS，我们确定了胆碱肌酸（Ch/Cr）在正常外观的右侧和左侧额叶白色物质的比例。29%的患者在PASAT上表现出工作记忆受损。总PASAT评分与右侧和左侧额叶白色物质Ch/Cr呈负相关。左额叶白色物质Ch/Cr与组块百分比相关，与二分体总数和百分比呈负相关。右额叶白色物质Ch/Cr与组块百分比相关，与总二分体和二分体百分比呈负相关。认知疲劳与左、右额叶白色Ch/Cr无相关性。病程越长，左额叶白色物质Ch/Cr越高。当考虑疾病持续时间时，左额叶白色物质Ch/Cr与总PASAT评分和总二对儿之间的相关性仍显着。SLE患者PASAT受损。较低的总PASAT评分和较少的二对儿与较高的左额叶微结构白色物质损伤相关，而认知疲劳则没有。这种模式表明，早期白色物质损伤干扰工作记忆系统性红斑狼疮，并提供了进一步了解轻度认知功能障碍的神经生物学基础与微结构白色物质损伤。
Many patients with systemic lupus erythematosus (SLE) have working memory deficits. Few studies have evaluated working memory performance and neurometabolite profile using magnetic resonance spectroscopy (MRS) in SLE. We gave the Paced Auditory Serial Addition Test (PASAT), a measure of working memory, to 73 patients with SLE. We calculated total score, dyads, chunking, and cognitive fatigue. Using MRS, we determined the ratio of choline to creatine (Ch/Cr) in normal-looking right and left frontal lobe white matter. Twenty-nine percent of patients showed impaired working memory on the PASAT. Total PASAT score inversely correlated with right and left frontal white matter Ch/Cr. Left frontal white matter Ch/Cr correlated with percent chunking and inversely correlated with total and percent of dyads. Right frontal white matter Ch/Cr correlated with percent chunking and inversely correlated with total and percent dyads. There was no relationship between cognitive fatigue and either left or right frontal white matter Ch/Cr. Longer disease duration was associated with higher left frontal white matter Ch/Cr. Correlations remained significant between left frontal white matter Ch/Cr and total PASAT score and total dyads when disease duration was considered. Patients with SLE were impaired on the PASAT. Lower total PASAT score and fewer dyads correlated with higher left frontal microstructural white matter damage, while cognitive fatigue did not. This pattern suggests that early white matter damage interferes with working memory in SLE and provides further insight into the neurobiological basis of mild cognitive dysfunction related to microstructural white matter injury.