COGNITIVE FUNCTION IN SYSTEMIC LUPUS ERYTHEMATOSUS

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 本方案旨在研究系统性红斑狼疮（SLE）受试者与匹配的正常健康对照组的认知功能随时间的变化。我们以前的工作表明，抗磷脂（aPL）和抗核糖体P（抗P）抗体的持续存在与SLE的认知功能障碍。此外，西班牙裔（HA）种族似乎是认知功能障碍的一个单独的风险因素。这一发现与其他研究中在非裔美国人（AA）和HA SLE患者中观察到的更严重的总体病程一致。本项目将检验的具体假设是：1。使用ANAM（自动神经心理学评估量表）和ACR（美国流变学学会）成套测验，确定SLE患者与健康对照组相比，认知功能定量指标随时间的变化幅度。2.确定SLE患者的认知功能障碍是否与持续阳性生物标志物水平相关。 研究计划：我们将从狼疮诊所招募SLE患者参加本研究。 符合4项或以上ACR修订的SLE分类标准的SLE受试者将有资格参加。男女都将参加。受试者不会因为当前有NPSLE（神经精神系统性红斑狼疮）表现或有NPSLE（神经精神系统性红斑狼疮）表现史而被排除。排除标准包括：既往使用ANAM的经验、导致意识丧失的头部创伤史、当前非法药物或酒精滥用、已知结构性脑损伤、无法完成研究随访、无法提供知情同意书。 参与者将被要求确定一位愿意参与研究的朋友作为对照受试者。 将按年龄（≤ 5岁）、教育、性别和种族将1例健康对照受试者与每例SLE受试者匹配。此外，如果对照组有可能与SLE诊断一致的临床或实验室异常，则将其排除。这将通过实施结缔组织疾病筛查问卷来确定。 方法：每6个月进行一系列神经学、认知、精神病学、流变学和免疫学评估。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This protocol is designed to study cognitive function over time in subjects with Systemic Lupus Erythematosus (SLE) versus a matched group of normal healthy controls. Our prior work demonstrates that the persistent presence of antiphospholipid (aPL) and anti-ribosomal P (anti-P) antibodies is associated with cognitive dysfunction in SLE. Also, Hispanic (HA) ethnicity appears to be a separate risk factor for cognitive dysfunction. This finding is consistent with the more severe disease course overall that has been observed in African American (AA) and HA SLE patients in other studies. The specific hypothesis which will be tested in this project are: 1. Determine the magnitude of change over time in the quantitative measures of cognitive function using ANAM (Automated Neuropsychological Assessment Metrics) and the ACR (American College of Rheumatology) battery among SLE patients compared with healthy controls. 2. Determine whether cognitive impairment in SLE patients is associated with persistently positive biomarker levels. RESEARCH PLAN: We will recruit SLE patients from the Lupus Clinic for enrollment in the study. SLE subjects meeting 4 or more ACR revised criteria for the classification of SLE will be eligible. Both women and men will be enrolled. Subjects will not be excluded because they currently have or have a history of NPSLE (Neuropsychiatric systemic lupus erythematosus) manifestations. Exclusion criteria include: prior experience taking ANAM, history of head trauma leading to loss of consciousness, current illicit drug or alcohol abuse, known structural brain lesion, inability to complete study follow-up, inability to give informed consent. Participants will be asked to identify a friend who is willing to participate in the study as a control subject. One healthy control subject will be matched to each SLE subject by age (¿5 years), education, gender, and ethnicity. In addition, controls will be excluded if they have clinical or laboratory abnormalities that could be consistent with the diagnosis of SLE. This will be determined by administering the Connective Tissue Disease Screening Questionnaire. METHODS: Serial neurological, cognitive, psychiatric, rheumatological, and immunological evaluations will be performed every 6 months.