Examination of Regression-based Discrepancy Scores for the RBANS in Detecting Cognitive Impairment from an Archival Sample

Association of lipoproteins and thyroid hormones with cognitive dysfunction in patients with systemic lupus erythematosus

Background

Neuropsychiatric manifestations occur in up to 75% of adult systemic lupus erythematosus (SLE) patients and are one of the major causes of death in SLE patients. Cognitive dysfunction is a typical clinical feature of neuropsychiatric SLE (NPSLE), which seriously affects the quality of life of patients. Dyslipidaemia and thyroid symptoms, which are prevalent in SLE patients, have both been related to neuropsychiatric disturbances, including significant psychiatric and cognitive disturbances. This study aimed to investigate whether cognitive dysfunction in patients with SLE was related to the expression of serum thyroid hormone and lipoprotein levels.

Methods

A total of 121 patients with SLE and 65 healthy controls (HCs) at Nanjing Drum Tower Hospital completed a cognitive function test, and 81 SLE patients were divided into a high-cognition (n = 33) group and a low-cognition group (n = 48). The clinical and laboratory characteristics of the patients were compared; moreover, correlations between serum HDL-C, LDL-C, F-T3 and F-T4 levels and cognitive function were analysed. Serum levels of APOE, APOA1, IGF-1, and IGFBP7 in 81 patients were detected by ELISA, and the correlation between these four proteins and cognition was analysed separately.

Results

The patients with SLE with abnormal cognitive function were less educated than the HCs. For low-cognition patients, the levels of albumin, F-T3 (P <  0.05) and F-T4 decreased, while D-dimer, anti-dsDNA antibody, and IgM levels increased. Serum F-T3 and F-T4 levels positively correlated with cognition. Furthermore, serum protein levels of APOE and APOA1 showed no difference between the high- and low-cognition groups. However, the serum APOE levels were negatively correlated with line orientation scores, and APOA1 levels were positively correlated with coding scores.

Conclusions

Serum F-T3 and F-T4 levels were both positively correlated with four indexes of cognition (language was the exception), while serum APOE levels were negatively correlated with line orientation scores, APOA1 levels were positively correlated with coding scores, and IGFBP7 levels were negatively correlated with figure copy scores. These results demonstrated that F-T3 and F-T4 might be clinical biomarkers of cognitive dysfunction in SLE.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41927-021-00190-7.

Reconsidering the RBANS Factor Structure: a Systematic Literature Review and Meta-Analytic Factor Analysis

The primary aim was to perform a systematic literature review and extract data necessary for a meta-analytic factor analysis of the RBANS. Secondary aims were to examine the potential validity and utility of the resulting factor structure. Literature was identified through a review of PsycINFO, PubMed, MEDLINE, Academic Search Complete, Psychology & Behavioral Sciences Collection, CINAHL Complete, Health Source: Nursing/Academic Edition, and SocINDEX. A two-stage meta-analytic structural equation modeling method was implemented to pool correlation matrices from primary studies and perform confirmatory factor analyses. Following model selection, factor scores were computed for two datasets and subjected to correlation and diagnostic accuracy analyses. A pooled correlation matrix was computed from 24 sample correlation matrices (N = 5299). Confirmatory factor analysis revealed that the theoretical five-factor model produced the best fit but only when error terms between Story Memory and Story Recall as well as between Figure Copy and Figure Recall were included. Regression-based factor scores showed mixed relationships with the manual-defined indices, and the overall diagnostic accuracy of the factor scores was adequate in both samples examined (AUC = 0.71 and 0.87). The five-factor model was an unexpected result given the failure of multiple previous studies to find support for that model. The five-factor model demonstrates several areas of potential improvement, including better representation of the factors by the indicators. The factor scores implied by this model also require further validation.