Estudo das manifestações neuropsiquiátricas nos pacientes com Lúpus Eritematoso Sistêmico do ambulatório de Reumatologia do Hospital das clínicas da Universidade Federal de Minas Gerais

Abstract

Purpose of the Study: Systemic Lupus Erythematosus (SLE) can affect the basal ganglia, as is the case of Lupus chorea. Basal ganglia dysfunction in other autoimmune diseases leads to aarray of neuropsychiatric non-motor symptoms, including obsessive-compulsive symptoms (OCS), executive dysfunction and attention deficit and hyperactivity disorder (ADHD). Objectives: To evaluate the frequency of neuropsychiatric manifestations, with emphasis on executive dysfunction, and the presence of OCD and ADHD in patients with SLE. Methods: Fifty-four subjects with SLE were submitted to a battery of neuropsychiatric tests that included the Mini Mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery, the FAS verbal and the categorical (animals) semantic fluency tests, the Obsessive and Compulsive Inventory Revised, the Yale-Brown Obsessive and Compulsive Scale and Becks Anxiety and Depression Scales. ADHD was diagnosed according to DSM-IV criteria. Results: Six(11.1%) and 33 (61.1%) patients had cognitive impairment according the MMSE and MoCA, respectively. 11 patients had abnormal FAB scores, and 5 (9.3%) had lower semantic fluency scores than expected. 15 (27.8%) had OCS, of which 5 (9.3%) had moderate to severe symptoms according to YBOCS. 17 (31.5%) met diagnostic criteria for ADHD. Executive dysfunction, depression and OCS correlated with disease activity. Discussion: Executive dysfunction, ADHD and OCS are common in SLE. The significance of basal ganglia dysfunction in SLE warrants further studies.