Sorting of 133 SLE patients with neuropsychiatric symptoms into 4 clusters by cluster analysis based on the results of a multiplex autoantibody profile and the presence of antiphospholipid antibodies/LAC.
| Characteristics | Cluster 1, none, n = 23 | Cluster 2, anti-dsDNA/anti-SSA/anti-SSB/anti-TRIM21, n = 40 | Cluster 3, Sm/RNP, n = 16 | Cluster 4, anti-dsDNA/LAC/aCL, n = 54 | p* | p of Grouped Clusters* 1–3 vs 4 |
|---|---|---|---|---|---|---|
| Female, % | 86.9 | 90 | 93.7 | 85.2 | 0.782 | 0.290 |
| Age, yrs, mean ± SD | 43.4 ± 15.3 | 44.8 ± 15.5 | 32.5 ± 10.6 | 42.7 ± 15.6 | 0.056 | 0.251 |
| No. SLE ACR criteria met, mean ± SD | 4.3 ± 0.8 | 4.8 ± 1.1 | 4.8 ± 1 | 4.7 ± 1.2 | 0.350 | 0.837 |
| Disease duration, yrs, mean ± SD | 8.9 ± 8.4 | 6.9 ± 7.9 | 6.1 ± 5.1 | 8.4 ± 9.1 | 0.612 | 0.371 |
| Duration of neuropsychiatric symptoms, yrs, mean ± SD | 2.1 ± 5.4 | 3.1 ± 5.2 | 1.5 ± 3.1 | 2.1 ± 3.1 | 0.629 | 0.142 |
| No. (%) diagnosis NPSLE | 12 (14.8) | 19 (23.5) | 12 (14.8) | 38 (46.9) | 0.068 | 0.047 |
| Comparison of the number and frequencies of different CNS NPSLE ACR syndromes between clusters** | ||||||
| Cerebrovascular disease | 5 (17.2) | 3 (10.3) | 3 (10.3) | 18 (62.1) | 0.03 | 0.009 |
| Headache | 4 (16) | 6 (28) | 2 (8) | 12 (48) | 0.853 | 0.287 |
| Psychosis | 2 (11.8) | 5 (29.4) | 0 (0) | 10 (58.8) | 0.251 | 0.092 |
| Seizure disorder | 1 (7.7) | 1 (7.7) | 1 (7.7) | 10 (76.9) | 0.048 | 0.007 |
| Cognitive dysfunction | 8 (19.5) | 8 (19.5) | 6 (14.6) | 19 (46.3) | 0.338 | 0.262 |
| Myelopathy | 0 (0) | 1 (14.3) | 0 (0) | 6 (85.7) | 0.096 | 0.019 |
| Mood disorder | 4 (20) | 7 (35) | 2 (10) | 7 (35) | 0.904 | 0.365 |
| Anxiety disorder | 3 (12.5) | 5 (20.8) | 3 (12.5) | 13 (54.23) | 0.228 | 0.097 |
| Acute confusional state | 1 (14.3) | 4 (57.1) | 1 (14.3) | 1 (14.3) | 0.370 | 0.138 |
| Movement disorder | 0 (0) | 1 (33.3) | 0 (0) | 2 (66.7) | 0.71 | 0.367 |
| Comparison of the number and frequencies of focal and diffuse CNS NPSLE ACR syndromes between clusters** | ||||||
| Focal | 7 (13.7) | 10 (19.6) | 6 (11.7) | 28 (54.9) | 0.06 | 0.010 |
| Diffuse | 9 (18.3) | 12 (24.5) | 6 (12.3) | 22 (44.9) | 0.341 | 0.341 |
| Major focal syndromes† | 5 (13.1) | 5 (13.1) | 4 (10.6) | 24 (63.2) | 0.008 | 0.001 |
| Major diffuse syndromes†† | 5 (15.1) | 11 (33.3) | 3 (9.1) | 14 (42.5) | 0.920 | 0.539 |
↵* Chi-square test. P values in bold face are statistically significant.
↵** Values are the no. (%) of patients per syndrome. Demyelinating syndrome and aseptic meningitis did not occur.
↵† Major focal syndromes include cerebrovascular disease, chorea, seizures, and myelopathy (according to ACR nomenclature).
↵†† Major diffuse syndromes include acute confusional state, mood disorder, and psychosis (according to ACR nomenclature). LAC: lupus anticoagulant; ACR: American College of Rheumatology; CNS: central nervous system; NPSLE: neuropsychiatric systemic lupus erythematosus; SLE: systemic lupus erythematosus; SLEDAI: Systemic Lupus Erythematosus Disease Activity Index; aCL: anticardiolipin.