This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor 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.
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