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Abstract Details

Disease Activity Independently Correlates with Cognitive Impairment in SLE
Autoimmune Neurology
P1 - Poster Session 1 (12:00 PM-1:00 PM)
C4 - Neuro-rheumatology (2:46 PM-2:56 PM)
1-028

To evaluate if NIHT can characterize CI in persons with SLE and if disease activity contributes to impaired cognition. 

 
Mechanisms driving cognitive impairment (CI) in systemic lupus erythematosus (SLE) remain poorly understood, and prior studies conflict regarding the relationship between CI and disease activity. The NIH Toolbox for Assessment of Neurological and Behavioral Function(NIHT) is used in Alzheimer’s disease, yet its value in measuring CI in SLE and relationship between NIHT subdomains and SLE disease activity remains unexplored.
Cross-sectional data were analyzed from adults meeting ≥4 of 11 ACR 1997 SLE criteria without concurrent autoimmune or neurologic diseases, infections, GFR<60, liver enzymes>3x ULN, or sodium imbalance. Cognition was assessed with Montreal Cognitive Assessment (MoCA) and six NIHT measures, including two executive function scales, Dimensional Change Card Sort (DCCS) and Flanker Inhibitory Control of Attention (FICA). SLEDAI-2K≥6 defined moderate-high disease activity; SLEDAI-2K<6 indicated low-moderate or inactive disease. Associations between continuous and categorical variables were assessed via Wilcoxon rank sum and t-tests. 
Our sample included 38 female and 1 male with SLE with a mean(SD) age of 34.16(11.25) years and mean disease duration of 9.67(8.40) years. Patients with moderate-high disease activity scored significantly lower(mean difference [MD])= -6.99, p.029) on FICA compared to those with low-moderate or inactive SLE, and lower(MD= -3.77, p.009) than general population controls within NIHT. Those with high disease activity also scored significantly lower (MD= -2.99, p.0245) on DCCS compared to general population controls. Findings were independent of race/age/education or SLEDAI subcomponent scores. MoCA did not differentiate groups. 
NIHT is a domain-specific, sensitive tool for detecting CI in SLE, outperforming MoCA. Higher SLEDAI correlate with executive function and memory impairments, supporting a role for generalized inflammation in SLE-related CI. We advance the field by exploring the link between SLE disease activity and CI in domains essential for daily functioning. 
Authors/Disclosures
Steven Bieser, MD (Northwestern University, McGaw Medical Center)
PRESENTER 		Dr. Bieser has nothing to disclose.
Asma Qureshi, MPH Miss Qureshi has nothing to disclose.
Komel Safdar, MBBS Dr. Safdar has nothing to disclose.
Mary Carns, MS Ms. Carns has nothing to disclose.
Vanessa Manada De Lobos Mrs. Manada De Lobos has nothing to disclose.
Emily A. Breach Ms. Breach has received research support from Rheumatology Research Fund.
Thales H. Hein da Rosa, MSc Mr. Hein da Rosa has nothing to disclose.
Mohammad Daud Khan, MS Mr. Khan has nothing to disclose.
Tyler Therron, MS Mr. Therron has nothing to disclose.
Katherine R. Puev Ms. Puev has nothing to disclose.
Anh H. Chung, BS Ms. Chung has nothing to disclose.
Neil Pillai, MS Mr. Pillai has nothing to disclose.
Kathleen Aren, MPH An immediate family member of Mrs. Aren has received personal compensation for serving as an employee of Salvation Army.
John Seagrist Mr. Seagrist has nothing to disclose.
Jing Song Mrs. Song has nothing to disclose.
Zachary Orban Mr. Orban has nothing to disclose.
Cecilia Stumpf Ms. Stumpf has or had stock in Gilead Sciences.Ms. Stumpf has or had stock in Novo nordisk.
Jason D. Ross, MD Dr. Ross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston scientific , Abbott, SPR. Dr. Ross has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific .
Harris Perlman, PhD Dr. Perlman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Arthritis Research and Therapy.
Yvonne C. Lee, MD Dr. Lee has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tonix Pharmaceuticals. Dr. Lee has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American College of Rheumatology. Dr. Lee has or had stock in GE Healthcare.Dr. Lee has or had stock in CVS Health. The institution of Dr. Lee has received research support from NIH/NIAMS. The institution of Dr. Lee has received research support from Rheumatology Research Foundation.
Deborah Winter, PhD Dr. Winter has nothing to disclose.
Borna Bonakdarpour, MD, FAAN (Mesulam Center for Cognitive Neurology and Alzheimer Disease) Dr. Bonakdarpour has nothing to disclose.
Mariam Siddiqui, MD Ms. Siddiqui has received personal compensation in the range of $0-$499 for serving as a Consultant for Abbvie. Ms. Siddiqui has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie.
Laura Arneson, MD Dr. Arneson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Werewolf Therapeutics.
Rosalind Ramsey-Goldman, MD, DrPH Dr. Ramsey-Goldman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB/Biogen. Dr. Ramsey-Goldman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Adicet. Dr. Ramsey-Goldman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autolus. Dr. Ramsey-Goldman has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Lupus Therapeutics. Dr. Ramsey-Goldman has received research support from NIH-to Northwestern University for my effort on the grant. Dr. Ramsey-Goldman has received research support from NIH-paid to Northwestern University for my effort ont he grant. Dr. Ramsey-Goldman has received personal compensation in the range of $10,000-$49,999 for serving as a consultant on grants with American College of Rheumatology-paid to Northwestern University for effort on grant. Dr. Ramsey-Goldman has received personal compensation in the range of $0-$499 for serving as a grant reviewer with Lupus Foundation of American.
Mary Mahieu, MD Dr. Mahieu has or had stock in Abbvie.Dr. Mahieu has or had stock in Abbott Laboratories.Dr. Mahieu has or had stock in Baxter International.Dr. Mahieu has or had stock in Johnson & Johnson.Dr. Mahieu has or had stock in Kimberly Clark.Dr. Mahieu has or had stock in Pfizer.Dr. Mahieu has or had stock in Takeda Pharmaceutical.
Lutfiyya N. Muhammad, PhD Dr. Muhammad has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American College of Surgeons. Dr. Muhammad has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Arthritis Research & Therapy.
Irene Blanco, MD Dr. Blanco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fate Therapeutics. Dr. Blanco has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Blanco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas Biopharma. Dr. Blanco has received research support from Cabaletta. Dr. Blanco has received research support from Novartis.
Eric B. Larson, PhD Dr. Larson has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Holland & Knight. Dr. Larson has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Gordon, Rees, Scully & Mansukhani.
Elena I. Grebenciucova, MD (Northwestern Unversity) Dr. Grebenciucova has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG therapeutics . Dr. Grebenciucova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen . Dr. Grebenciucova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Grebenciucova has received research support from Lupus Research Alliance .
Carla M. Cuda, PhD Dr. Cuda has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Arthritis Research & Therapy. The institution of Dr. Cuda has received research support from NIH NIAID.