Dissertations, Theses, and Capstone Projects

Date of Degree

6-2017

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Justin Storbeck

Committee Members

Joan Borod

Carolyn Pytte

Jennifer Stewart

Daniel Fienup

Subject Categories

Clinical Psychology | Cognition and Perception | Cognitive Psychology | Health Psychology | Other Mental and Social Health | Other Psychology

Keywords

Lupus, SLE, Autoantibodies, NR2, DNR, Hippocampus

Abstract

Individuals with Systemic Lupus Erythematosus (SLE) experience inflammation that may target any organ within the body, including the central and peripheral nervous systems. Additionally, these individuals often demonstrate psychological dysfunctions including emotional and cognitive deficits; however, research is inconsistent as to the nature and cause of these dysfunctions. While there are multiple factors that may increase risk for variability in cognitive function, such as population differences, socioeconomic status (SES), mood disorders (depression and anxiety), medication effects, and disease activity, these factors do not reliably predict the severity and extent of cognitive deficits. A growing body of animal research associates autoantibodies (Abs) in SLE with cognitive impairment. A specific Ab that targets N- methyl-D-aspartate receptors (NMDAR) and neuronal DNA, referred to as DNRAb, is associated with hippocampal damage and spatial memory deficits in mice. The goal of this project was to examine the relationship between the DNRAb and cognitive deficits specific to spatial-relational learning and memory within a sample of SLE patients. Two cohorts of healthy controls (HCs) and SLE patients were recruited. Cohort A included 33 HCs and 39 SLE participants (23 DNRAb-, 11 DNRAb+, 5 unknown Ab status). Cohort B included 11 HCs and 21 SLE participants (11 DNRAb-, 10 DNRAb+). All participants completed measures of emotional functioning and neuropsychological measures of visuospatial learning and memory, processing speed, and executive function. Cognitive testing of spatial memory and relational learning was evaluated by two laboratory-developed computerized tasks. Antibody status was determined after participants were recruited in the study. Overall, compared to SLE patients, HCs were significantly more accurate, and thus had better performance on the Spatial Memory and Relational Learning Tasks. The DNRAb+ group was significantly less accurate than HC on both computerized measures. However, the DRNAb- did not differ from either groups on the Spatial Memory Task, and performed similarly to the DRNAb+ group on the Relational Learning Task. This work provides a foundation for future research to analyze how SLE and Ab status could influence cognitive functioning. Future studies can continue to examine subtle cognitive deficits in SLE, consider the possibility of other brain areas to compensate for cognitive deficits in SLE, and provide additional breakthroughs to guide interventions for SLE patients.

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