AB0410 COGNITIVE DYSFUNCTION IN PRIMARY SJÖGREN’S SYNDROME AND SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: M. J. Garza Martínez, M. A. Treviño-Castro, I. D. J. Hernandez-Galarza, A. Cárdenas, R. Pineda, C. V. Solis, J. C. Riegatorres, C. M. Skinner Taylor, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2020)

Background: Primary Sjögren’s syndrome (pSS) and systemic lupus erythematosus (SLE) share several clinical manifestations including neurological involvement. Cognitive dysfunction is a common neuropsychiatric manifestation in both, but evaluation and diagnosis is often challenging and delayed. The Automated Neuropsychological Assessment Metrics (ANAM) is a computerized cognitive screening tool that does not need specialized personnel to apply and is less time consuming than other tests. Objectives: Assess cognitive function of SLE and pSS patients with a computer-based tool (ANAM) in a single rheumatology clinic, compare its performance, and record their clinical and demographic characteristics Methods: We recruited patients from the rheumatology clinic of the UANL University Hospital who met the pSS 2002 AECG or ACR-EULAR 2016 classification criteria and SLE patients fulfilling SLICC 2012 criteria. We defined mild cognitive impairment as 1 to 1.9 SD below controls, and moderate-severe cognitive impairment as 2 SD or more below the comparison group (subjects matched by age, sex, ethnicity and educational level by the ANAM program) as previously employed in SLE. Percentages were used for categorical variables and means (±SD) for numerical ones. To observe differences between groups, chi square and Student´s t were used, p &lt;0.05 was considered significant. Results: A significant difference was observed in the total ANAM score between SLE and pSS patients (Table 1). In SLE, the most affected domains were simple reaction time, code substitution and delayed memory; in pSS patients, the most affected domains were inhibition and spatial work memory (Table 2). Table 1. Differences in ANAM performance between pSS and SLE. Variable pSS mean, (SD ) SLE mean, (SD ) p Female, % 92.2 93.5 0.77 Age (years) 56.25 (10.45) 31.99 (13.17) 0.001 Disease duration (years) 6.38 (6.15) 5.61 (6.1) 0.492 ANAM total score -1.43 (0.85) -1.87 (0.96) 0.008 Simple reaction time 25.5 54.5 0.001 Simple reaction time score 148.39 (32.44) 144.13 (52.37) 0.571 Code substitution (Learning) 13.7 9.1 0.411 Code substitution (Learning) score 33.39 (8.42) 38.61 (14.23) 0.001 Procedural reaction time-Attention 15.7 27.3 0.125 Procedural reaction time-Attention score 70.29 (12.11) 73.17 (17.68) 0.277 Mathematical processing 11.8 13 0.838 Mathematical processing score 17.92 (11.07) 15.57 (6.63) 0.177 Matching to sample-spatial work memory 21.6 7.8 0.025 Matching to sample-spatial work memory score 20.08 (7.66) 22.26 (8.72) 0.139 Code substitution-delayed memory 15.7 7.8 0.161 Code substitution-delayed memory score 26 (11.57) 33.69 (18.99) 0.005 Simple reaction time 21.6 32.9 0.165 Simple reaction time score 148.88 (24.82) 166.29 (38.87) 0.004 Go/No-Go, Inhibition 21.6 5.2 0.005 Go/No-Go, Inhibition score 3.41 (1.57 3.27 (1.68) 0.635 Conclusion: Cognitive impairment was common in both diseases but the cognitive domains affected were different. Rheumatologists should be aware of these differences when evaluating cognitive dysfunction in SLE and pSS patients. References: [1]Kurtuluş F, Çay H, Parlak E, Yaman A. Montreal cognitive assessment in primary sjogren’s syndrome. A brief screening tool. Neurosciences. 2019;24(3):199-206. [2]Tayer-Shifman O, Green R, Beaton D, Ruttan L, Wither J, Tartaglia M et al. Validity evidence supports the use of automated neuropsychological assessment metrics as a screening tool for cognitive impairment in lupus. Arthritis Care &amp; Research. 2019;. Disclosure of Interests: None declared