Cardiopulmonary correlates of cognitive function in SLE

SLE 认知功能的心肺相关性

• 批准号: 8045820
• 负责人: ELIZABETH KOZORA
• 金额: $ 16.61万
• 依托单位: NATIONAL JEWISH HEALTH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-27 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8045820
• 关键词: Activities of Daily Living; Affect; Age; Autoantibodies; Autoimmune Diseases; Autoimmune Process; Blood Vessels; Brain; Cardiac; Cardiopulmonary; Cardiovascular system; Chronic; Chronic Obstructive Airway Disease; Clinical; Cognition; Cognitive; Cognitive deficits; Control Groups; Development; Diagnosis; Disease; Effectiveness; Elderly; Exercise; Functional disorder; Future; Heterogeneity; Impaired cognition; Individual; Intervention; Investigation; Laboratories; Length; Life; Lung; Lung diseases; Measures; Medical; Memory Disorders; Mental Depression; Minor; Modeling; Nature; Organ; Oxygen Consumption; Pathogenesis; Patient Self-Report; Patients; Performance; Pharmaceutical Preparations; Physical activity; Physiological; Pilot Projects; Population; Production; Psychophysiology; Public Health; Questionnaires; Recruitment Activity; Reporting; Respiratory physiology; Rheumatoid Arthritis; Sampling; Severity of illness; Sjogren' s Syndrome; Solutions; Structure; System; Systemic Lupus Erythematosus; Testing; Treatment Protocols; Walking; Workload; base; chronic autoimmune disease; cognitive function; cohort; cost; design; disease characteristic; effective therapy; illness length; improved; middle age; neurobehavioral; neuropsychiatry; novel; programs; psychologic; public health relevance; treatment program

DESCRIPTION (provided by applicant): Cognitive dysfunction is common in patients with autoimmune disorders such as systemic lupus erythematosus (SLE). These deficits can impact a wide range of activities and a better understanding of the nature and pathogenesis is critical to developing effective treatment approaches in these patients. Despite many prior investigations into autoimmune and vascular abnormalities associated with brain dysfunction in SLE, no one specific underlying mechanism has emerged. SLE is a multi-organ disease and pulmonary involvement has been identified in up to 60% of SLE patients. In a small sample of SLE subjects we found unexpected pulmonary abnormalities related to cognitive dysfunction and our first aim in this study is to compare lung function and exercise capacity in a larger cohort of SLE and control subjects, and evaluate the relationship between lung function, exercise capacity and cognition. The model is based on prior studies in patients with chronic obstructive pulmonary disease (COPD) where cognitive deficits have been associated with poor lung function, exercise capacity and depression. Given the heterogeneity of SLE manifestations we will minimize diversity in some factors (i.e. age, length of diagnosis, disease severity and medication use). We also aim to evaluate and validate the use of brief self-report measures of exercise that are easy to obtain, applicable and valid for this population. This will allow development of larger, cost-effective treatment protocols for future investigations. Finally, we aim to examine whether or not exercise improves cognitive function in a small sample of mildly diseased middle aged SLE patients with established disease duration. If improvement is noted we will explore predictors common to other populations (i.e. lung function, exercise capacity and depression) as well as factors specific to autoimmune SLE disease characteristics as mechanisms of change. Ultimately, we aim to use this pilot study to evaluate the feasibility and utility of cardiopulmonary exercise as an intervention and to guide the design of larger trials that will examine the effectiveness of such an intervention in treating cognitive dysfunction in patients with SLE and possibly other rheumatic autoimmune disorders. PUBLIC HEALTH RELEVANCE: Cognitive dysfunction in patients with systemic lupus erythematosus (SLE) is common, and yet mechanisms remain unclear and treatment options limited. This pilot study will investigate basic pulmonary problems and/or exercise limitations contributing to cognitive dysfunction in SLE. It will also examine whether an exercise program for this group is feasible and demonstrates improvement on cognitive ability. Developing novel treatments for cognitive dysfunction in SLE could have positive effects for public health in these and other autoimmune patients.

描述（由申请人提供）：自身免疫性疾病（如全身性红斑狼疮）（SLE）等自身免疫性疾病的患者（SLE）常见认知功能障碍。这些缺陷会影响广泛的活动，并且更好地了解性质和发病机理对于开发这些患者的有效治疗方法至关重要。尽管对SLE中脑功能障碍相关的自身免疫和血管异常进行了许多先前的研究，但没有出现过特定的潜在机制。 SLE是一种多器官疾病，在多达60％的SLE患者中已经发现了肺部受累。在一小部分SLE受试者样本中，我们发现与认知功能障碍有关的意外肺异常，这项研究的第一个目的是比较较大的SLE和控制受试者中的肺功能和运动能力，并评估肺功能，运动能力，运动能力和认知之间的关系。该模型基于对慢性阻塞性肺疾病（COPD）患者的先前研究，在该患者中，认知缺陷与肺功能不良，运动能力和抑郁症有关。鉴于SLE表现的异质性，我们将最大程度地减少某些因素的多样性（即诊断的年龄，疾病严重程度和药物使用）。我们还旨在评估和验证易于获得，适用且适用于该人群的简短自我报告练习测量。这将允许制定更大的，具有成本效益的治疗方案，以进行未来的研究。最后，我们旨在检查运动是否可以改善较轻度疾病的中年疾病患者的少数样本中的认知功能。如果注意到改善，我们将探索其他人群共有的预测因素（即肺功能，运动能力和抑郁症），以及特定于自身免疫性SLE疾病特征的因素作为变化的机制。最终，我们旨在利用这项试验研究来评估心肺运动的可行性和实用性作为干预措施，并指导大型试验的设计，这些试验将研究这种干预措施治疗SLE和可能其他风湿性自身免疫性疾病的认知功能障碍的有效性。 公共卫生相关性：全身性红斑狼疮（SLE）患者的认知功能障碍是常见的，但机制仍然不清楚，治疗方案有限。这项试点研究将研究基本的肺部问题和/或运动限制，导致SLE认知功能障碍。它还将检查该组的锻炼计划是否可行，并证明认知能力的改善。在SLE中，开发针对SLE认知功能障碍的新型治疗方法可能会对这些和其他自身免疫性患者产生积极影响。