Lupus and the Brain: Unpacking the Mind-Body Connection

The central nervous system, which consists of the brain and spinal cord, can be attacked by lupus’ harmful autoantibodies. Damage from lupus on the central nervous system can eventually lead to common symptoms such as brain fog, headaches, and mood disorders. This article will view lupus under a neuropsychiatric lens and how attacks from the body’s own immune system can lead to dangerous effects to the brain.

*Disclaimer:

The information provided in this article is for general informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional diagnosis, treatment, or advice from a qualified healthcare provider. Reliance on any information provided in this article is solely at your own risk.

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The central nervous system works hard to receive sensory information from your environment, interpret it in seconds, and respond with the proper action. It is able to carry out this delicate operation behind every move you make because it communicates with another vital system in your body: the peripheral nervous system. Signals are constantly being passed back and forth between the peripheral nervous system and the central nervous system.

However, lupus leads to the body’s immune system producing harmful antibodies that bind to nerve cells, interrupting communications within your nervous system that results in cognitive dysfunction like confusion, memory loss, and difficulty expressing yourself. Interruptions in your nervous system might also lead to headaches or anxiety. Antibodies can also bind to the blood vessels that are essential to nerve cells’ survival, thus interrupting blood flow to nerves. These abnormalities in a patient’s blood flow can lead to a lack of oxygen flowing to the brain, worsening cognitive dysfunction. Moreover, lupus can also leverage neurotransmitters such as adrenaline to breach the highly selective blood-brain barrier, determine the region of the brain most vulnerable to autoantibodies that are poisonous to the nervous system, and attack the brain directly.

Overactive lupus or lupus flares can also lead to the release of proteins called cytokines that can inflame the brain. Additionally, patients that have lupus and develop blood clots (whether because of inflamed blood vessels or antiphospholipid antibodies) can have blood clots traveling to or occurring in the brain, leading to strokes.

Lupus that affects the central nervous system or peripheral nervous system is called neuropsychiatric lupus. Approximately 14% to over 80% of adult lupus patients and 22% to 95% of child patients experience neuropsychiatric lupus. Symptoms other than the ones previously mentioned can include:

• Seizures Psychosis Myelitis (inflammation of the spinal cord)

• Vision loss

• Face pain

• Hearing issues such as ringing in the ears

• Dizziness

• Fibromyalgia (chronic pain sensitization disorder believed to result from central nervous system pain pathways)

It is important that if you believe you are suffering from neuropsychiatric lupus that you attend to it as quickly as possible and alert your doctor. Communication is key behind an effective treatment.

However, neuropsychiatric lupus’ symptoms are often broad and overlap with diseases that are present in patients without lupus. This might complicate diagnosis, as your physician needs to evaluate your medical history, conduct a physical examination, and take blood and urine tests to confidently determine that symptoms arise from neuropsychiatric lupus and not a separate affliction.

They may also ask for a spinal tap or MRI. Common indicators of neuropsychiatric lupus your physician may find during medical tests are an irregular blood count, the presence of antiphospholipid antibodies, or inflamed kidneys.

Subsequent treatment is also complicated by the significantly varying levels of intensity neuropsychiatric lupus can manifest as. The most common therapeutic is glucocorticoids, also known as corticosteroids or simply steroids. These are prescription medications often used when neuropsychiatric manifestations result from flare ups. Other treatments may be:

• Blood thinners

• Anti-seizure medication

• Mood-stabilizers

• Anti-psychotics

• Immunosuppressants

The Lupus Foundation of America also recommends these strategies to cope with brain fog and cognitive issues stemming from neuropsychiatric lupus:

• Taking on tasks one at a time

• Repeating important information aloud or writing it down

• Keeping an organized calendar for appointments and reminders

• Using visual cues

• Taking your time with certain tasks

• Seeking support groups

Neuropsychiatric lupus is an extremely common form of lupus that results from harmful autoantibodies from your immune system attacking your central nervous system or peripheral nervous system. Abnormalities within your blood or overactive lupus can range from mild symptoms, such as brain fog and headaches, to intense symptoms such as fibromyalgia. It can be difficult to seek treatment for neuropsychiatric lupus due to the broad range of symptoms however, with proper communication and coping mechanisms, you can find the right treatment plan for you.

Central Nervous System (CNS) | Cleveland Clinic

Corticosteroids (Glucocorticoids) | Cleveland Clinic

Nervous System | John Hopkins Lupus Center

Lupus and the nervous system | Lupus Foundation of America

Neuropsychiatric Systemic Lupus Erythematosus | National Library of Medicine

Neuropsychiatric Lupus – Lupus and the Brain | Hospital for Special Surgery

Lupus and Brain Fog | Lupus Foundation of America