ROBIN BREY

..Both approaches promise to identify predictors of specific nervous system manifestations that may suggest novel and more specific therapeutic interventions...

..Methods that evaluate metabolic processes and other functional imaging techniques have more promise as surrogates for central nervous system damage. This article reviews the current literature on clinical and imaging aspects of NPSLE...

..Antiphospholipid antibodies have been associated with a clinical syndrome consisting thrombosis and recurrent, unexplained fetal loss...

..To systematically review evidence from clinical trials about the management of neurological manifestations of Antiphospholipid Syndrome (APS)...

..Recommendations are made regarding further research that is needed to clarify remaining uncertainties...

..In the absence of data to guide clinicians on the best treatment, we cannot make strong recommnendations as to optimal therapy, nor can we propose clear consensus treatment guidelines...

..In this mini-review, most of the neurologic syndromes with an actual or suspected association with aPL are considered. The role of aPL in the differential diagnosis of these syndromes is considered as well...

..The San Antonio Lupus Study of Neuropsychiatric Disease is a longitudinal study designed to characterize the spectrum of and important risk factors for specific neuropsychiatric systemic lupus erythematosus (NPSLE) syndromes...

..The presence of antiphospholipid antibodies (aPL) has been associated with vascular occlusive events. However, the role of aPL in predicting ischemic events, particularly recurrent ischemic stroke, is controversial...

..Modifiable cardiac risk factors and valvular heart disease may worsen APS cerebrovascular outcomes. Adjunctive therapies (eg, statins, antimalarials, and angiotensin-converting enzyme inhibitors) warrant clinical trials...

..87 (95% confidence interval, 1.24 to 2.83; P=0.0027). CONCLUSIONS: The results from this study support the importance of antiphospholipid antibodies as an independent risk factor for stroke in young women...

..PFO is associated with cryptogenic ischemic stroke. Also, the presence of aPL is associated with ischemic cerebrovascular disease...

..Elevated levels of all soluble adhesion molecule levels correlated with abnormal levels of antiphospholipid antibodies, which are associated with some NPSLE manifestations and have been shown to upregulate adhesion molecule expression...

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..The management of NPSLE includes symptomatic and/or immunosuppressive treatment strategies depending on the specific presenting neuropsychiatric symptoms and whether these occur in the setting of an SLE disease activity flare...

..Cognitive dysfunction and psychiatric disorders are the two most common manifestations. The work-up and treatment of nervous system syndromes are also discussed...

..In this issue of Neurology, Drummond reports on a study that evaluated whether low brain levels of serotonin trigger motion sickness in people with and without migraine. More information about migraine can be found on the next page...

..The information that will be gained from this study is essential for the successful discovery of biological processes that impact on cognitive function in SLE that could be potentially amenable to disease-reversing therapies. ..

..The information that will be gained from this study is essential for the successful discovery of biological processes that impact on cognitive function in SLE that could be potentially amenable to disease-reversing therapies. ..

..Much will be learned about the relative importance of genetic factors and autoantibodies on vascular disease risk in SLE that is likely to apply to other populations also at increased risk for cerebral ischemia and vascular dementia. ..

..The information gained will bridge important gaps in our knowledge about NS involvement in SLE and will lead to new hypothesis-driven studies of etiopathogenesis and treatment. ..

..The information that will be gained from this study is essential for the successful discovery of biological processes that impact on cognitive function in SLE that could be potentially amenable to disease-reversing therapies. ..