Open AccessMemory Dysfunction in Primary Sjögren's Syndrome Is Associated With Anti‐NR2 Antibodies
Author(s) -
Lauvsnes Maria B.,
Maroni Stian S.,
Appenzeller Simone,
Beyer Mona K.,
Greve Ole J.,
Kvaløy Jan T.,
Harboe Erna,
Gøransson Lasse G.,
Tjensvoll Anne B.,
Omdal Roald
Publication year - 2013
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.38127
Subject(s) - antibody , medicine , depression (economics) , cerebrospinal fluid , anti nuclear antibody , etiology , neuropsychology , immunology , pathogenesis , gastroenterology , psychiatry , autoantibody , cognition , economics , macroeconomics
Objective Our understanding of the etiology and pathogenesis of neuropsychiatric involvement in primary Sjögren's syndrome (SS) is incomplete. In systemic lupus erythematosus, it has been reported that antibodies directed against N ‐methyl‐ D ‐aspartate receptor subtype NR2 (anti‐NR2) interfere with memory and learning function, as well as mood. This has not been investigated in primary SS; however, the present study was undertaken to advance our understanding of neuropsychiatric involvement in this disease. Methods Sixty‐six patients with primary SS and 66 age‐ and sex‐matched healthy control subjects underwent clinical examination and neuropsychological evaluation. Anti‐NR2 antibodies were measured in serum and cerebrospinal fluid. Hippocampus volume was estimated using software extensions to SPM5. Results Patients with primary SS had smaller hippocampi than healthy subjects (mean ± SD 8.15 ± 0.98 cm 3 versus 8.49 ± 0.88 cm 3 ; P = 0.01). In patients with primary SS, anti‐NR2 antibodies in cerebrospinal fluid were associated with a worse performance in 8 of 10 memory and learning tests, and anti‐NR2 antibodies in serum were associated with a worse performance in 6 of those same tests. In addition, a higher proportion of patients with depression than patients without depression had serum anti‐NR2 antibody levels above the cutoff value. Conclusion Results of this study indicate that anti‐NR2 antibodies may represent one of the pathogenetic mechanisms for cognitive disturbances and mood disorders in patients with primary SS.