Multimodal neurophysiological and psychometric evaluation among patients with systemic lupus erythematosus

Ghaydaa A Shehata¹, Yasser MB Elserogy², Hossam Eddin K Ahmad², Mohamed I Abdel-Kareem³, Ashraf M Al-kabeer⁴, Mohamed M Rayan², Mohamed ES Abd El-Baky
 ¹Department of Neurology; ²Department of Psychiatry, Assiut University, Egypt; ³Department of Rheumatology, Physical Medicine and Rehabilitation; ⁴Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

Objective: To determine some of the neuropsychiatric manifestations of systemic lupus erythematosus (SLE) by applying multimodal neurophysiological and psychometric studies.
Patients and methods: Twenty-six SLE patients were evaluated for neurological and psychiatric disorders and compared with 26 healthy controls matched for age, sex, education, and social class. The severity of SLE disease was assessed. Each subject was subjected to the following examinations: laboratory, neurophysiology, magnetic resonance imaging of the brain, transcranial duplex, Modified Mini-mental State Examination, Cognitive Assessment Scale Inventory, Hamilton Depression Scale, and Hamilton Anxiety Scale.
Results: The mean age of subjects was 25.9 ± 8.9 years. The most prevalent neurological manifestations were (in order of frequency) anxiety in 17 cases (65.4%), depression in 15 cases (57.7%), headache in 10 cases (38.5%), peripheral neuropathy in 7 cases (26.9%), seizures in 6 cases (23.1%), psychosis in 5 cases (19.2%), dementia in 4 cases (15.4%), radiculopathy in 4 cases (15.4%), myositis in 3 cases (11.5%), and stroke in 2 cases (7.7%). There was a significant affection in amplitude of the ulnar nerve, cognitive function impairment, and electroencephalography changes. There was a significant increased mean velocity and decreased Pulsatility Index of the most studied intracranial vessels in the patients.
Conclusion: The use of multimodal neurophysiological, transcranial duplex, and psychometric scales increases the sensitivity for detecting nervous system involvement.

Keywords: SLE, SLEDAI, cognitive function, depression, anxiety, neurological disorders

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