{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:45:43Z","timestamp":1793857543505,"version":"4.6.1"},"reference-count":50,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2021,7,17]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare cognitive function between patients with different phenotypes of neuropsychiatric systemic lupus erythematosus (NPSLE) and assess its association with brain and white matter hyperintensity (WMH) volumes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients attending the Leiden University Medical Centre NPSLE clinic between 2007 and 2015 without large brain infarcts were included (n=151; 42\u00b113 years, 91% women). In a multidisciplinary consensus meeting, neuropsychiatric symptoms were attributed to systemic lupus erythematosus (SLE) (NPSLE, inflammatory (n=24) or ischaemic (n=12)) or to minor\/non-NPSLE (n=115). Multiple regression analyses were performed to compare cognitive function between NPSLE phenotypes and to assess associations between brain and WMH volumes and cognitive function cross-sectionally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Global cognitive function was impaired in 5%, learning and memory (LM) in 46%, executive function and complex attention (EFCA) in 39% and psychomotor speed (PS) in 46% of all patients. Patients with inflammatory NPSLE showed the most cognitive impairment in all domains (p\u22640.05).<\/jats:p>\n                    <jats:p>Higher WMH volume associated with lower PS in the total group (B: \u22120.14 (95% CI \u22120.32 to \u22120.02)); especially in inflammatory NPSLE (B: \u22120.36 (95% CI \u22120.60 to \u22120.12). In the total group, lower total brain volume and grey matter volume associated with lower cognitive functioning in all domains (all: 0.00\/0.01 (0.00;0.01)) and lower white matter volume associated with lower LM, EFCA and PS (all: 0.00\/0.01 (0.00;0.01)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We demonstrated that an association between brain and WMH volumes and cognitive function is present in patients with SLE, but differs between (NP)SLE phenotypes. WMHs associated with PS especially in inflammatory NPSLE, which suggests a different, potentially more severe underlying pathophysiological mechanism of cognitive impairment in this phenotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-001650","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T12:17:29Z","timestamp":1627474649000},"page":"e001650","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["White matter hyperintensities associate with cognitive slowing in patients with systemic lupus erythematosus and neuropsychiatric symptoms"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-7085","authenticated-orcid":false,"given":"Rory Caitlin","family":"Monahan","sequence":"first","affiliation":[{"name":"Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4569-4272","authenticated-orcid":false,"given":"Francesca","family":"Inglese","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huub","family":"Middelkoop","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands"},{"name":"Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"van Buchem","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-7520","authenticated-orcid":false,"given":"Tom WJ","family":"Huizinga","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margreet","family":"Kloppenburg","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands"},{"name":"Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itamar","family":"Ronen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerda M","family":"Steup-Beekman","sequence":"additional","affiliation":[{"name":"Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands"},{"name":"Department of Rheumatology, Medisch Centrum Haaglanden, the Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"de Bresser","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,28]]},"reference":[{"key":"2025090312303842000_7.2.e001650.1","doi-asserted-by":"crossref","unstructured":"RC H , Husain SF , CS H . 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