Lupus Disease Activity Correlates With Cognition, With Carla Marie Cuda, PhD

Cognitive impairment, as measured on the National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function, correlated with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores in new research that brings attention to quality of life issues in people with SLE.

These findings were presented at the American College of Rheumatology (ACR) Convergence 2025, held October 24–29 in Chicago, Illinois, by Carla Marie Cuda, PhD, Solovy/Arthritis Research Society Research Professor of Medicine (Rheumatology) at Northwestern Feinberg School of Medicine.

Cuda and colleagues assessed 22 female patients with SLE free of concurrent autoimmune or neurologic disease with a mean age of 33.8 years (standard deviation [SD], 11.8) and disease duration of 8.9 years (SD, 6.0). They found that patients with moderate-high disease activity scored lower on the Dimensional Change Card Sort and Rey Auditory Verbal Learning Tests for executive function and delayed auditory-verbal memory, respectively, compared to those with inactive or low-moderate disease activity. Interestingly, low circulating complement C4 correlated with worse delayed auditory-verbal memory. The study validated the sensitivity of the NIHT as the clinically validated Montreal Cognitive Assessment (MoCA) did not reveal any differences between groups in the study.

HCPLive spoke with Cuda to learn more about the study and its findings. She shared some surprising observations made in the study that require further research, including hte link between circulating complement C4 correlated and auditory-verbal memory.

"I think the potential that, if you control [disease activity] that you can also improve someone's cognition would be very interesting, and especially if that then gets integrated into trials. A lot of these not-easily quantifiable symptoms are not being included necessarily for patients in clinical trials. So if that becomes a way in which to start to adjust for this and include patients and see if any of these drugs can actually impact cognition, would be amazing, and I think patients would want it, definitely," Cuda said.

Reference

Beiser S, Qureshi A, Safdar K, et al. Disease Activity Independently Correlates with Cognitive Impairment in Systemic Lupus Erythematosus.