Lupus Science & Medicine
Figure 2 Comparison of brain injury markers between cSLE and controls. Shown are proportions of participants with cognitive impairment, compared between cSLE and control groups using the χ 2 test with significant p value <0.05 indicated by *. Cognitive function domains were measured as follows: (1) executive function by the Delis-Kaplan Executive Function System (DKEFS) Colour Word Interference Test; (2) attention by the Conners Continuous Performance Test third edition (CPT-3); (3) working memory by the Wechsler Intelligence Scale for Children fifth Edition (WISC-V)/Wechsler Adult Intelligence Scale, fourth Edition (WAIS-IV) Digit Span Test. Overall CD: (a) performance on any of the cognitive domain tests of ≥2 SD poorer than the mean standardised a score or (b) performance on at least two tests (from different cognitive domains) of at least one SD poorer than the mean standardised score. Severe CD: performance on any of the cognitive domain tests of ≥2SD poorer than the mean standardised score (definitions for overall CD and severe CD were therefore not mutually exclusive). Domain-specific CD: performance at least one SD poorer than the mean standardised score. CD, cognitive dysfunction; cSLE, childhood-onset SLE.
DISCUSSION In this cSLE cohort, we examined relationships between serum brain injury markers, measures of systemic inflam- mation and cognitive function. We found that adolescents with cSLE had significantly higher serum levels of GFAP,
2.5, IQR 1.2–4.9, p<0.001), serum IL-6 (median 3.16pg/mL, IQR 1.20–10.70vs 1.00 pg/mL, IQR 0.62–1.73, p<0.001) and current GC dose at visit (median 10mg, IQR 7.5–17.5vs 0 mg, IQR 0–3.0, p<0.001), all statistically significant for a corrected p value <0.0025.
Table 3 Brain injury marker levels by level of cognitive dysfunction for cSLE and controls Moderate-severe CD Severe CD Absent, median (IQR) Present, median (IQR) Z-statistic, P value Absent, median (IQR) Present, median (IQR)
Z-statistic, P value
cSLE (n=55) sNFL 4.92 (3.60–6.53) GFAP 90.05 (64.70–127.0) Tau 2.64 (1.97–3.93) Controls (n=43) sNFL 4.81 (3.65–7.32) GFAP 74.30 (57.80–91.40) Tau 2.43 (1.97–3.08)
6.05 (4.68–16.3)
−1.91, 0.056 4.99 (3.93–7.29)
6.05 (4.65–8.59)
−1.13, 0.264 −1.61, 0.109 −3.94, <0.001 *
131.0 (114.0–216.0) −2.17, 0.029
93.75 (64.70–132.0)
125.0 (114.0–151.0)
−3.60, <0.001*
4.58 (3.44–7.07)
2.74 (1.97–4.10)
4.58 (3.44–7.07)
3.89 (3.41–5.46)
0.78, 0.449
4.77 (3.58–7.32)
3.99 (2.67–6.87)
0.63, 0.556 0.50, 0.643 −1.84, 0.068
73.80 (34.70–102.0) 0.09, 0.944
74.30 (56.90–91.60)
60.25 (33.50–94.90)
−2.13, 0.033
3.33 (2.65–5.01)
2.56 (2.01–3.21)
5.15 (3.58–5.65)
Shown are group comparisons of brain injury marker levels (median, IQR in pg/mL) by cognitive dysfunction group for cSLE and control participants using the Wilcoxon rank-sum test; p values <0.05 are in bold and those with an asterisk are significant after Bonferroni correction (p<0.004). Moderate-severe CD: performanceon any of the cognitive domain tests of 2 SD poorer than the mean standardised score and/ or performance on at least two tests (from different domains) of one SD poorer than the mean standardised score. Severe CD: performance on any of the cognitive domain tests of 2 SD poorer than the mean standardised score. *Indicates significance of p<0.004 after Bonferroni correction. CD, cognitive dysfunction; cSLE, childhood-onset SLE; GFAP, glial fibrillar acidic protein; sNFL, serum neurofilament light.
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Mwizerwa O, et al . Lupus Science & Medicine 2026; 13 :e001922. doi:10.1136/lupus-2025-001922
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