Use of computerized assessment to predict neuropsychological functioning and emotional distress in patients with systemic lupus erythematosus.

Full Abstract

OBJECTIVE:
Cognitive dysfunction and neuropsychiatric disturbance are common in systemic lupus erythematosus (SLE). This study addressed the ability of the Automated Neuropsychological Assessment Metrics (ANAM), a computerized cognitive testing battery consisting of cognitive subtests, a sleepiness rating scale, and a mood scale, to predict neuropsychological status in patients with SLE.

METHODS:
Sixty individuals with SLE and no overt neuropsychiatric symptoms were administered ANAM to determine its validity as a screening measure of cognitive dysfunction and emotional distress in SLE.

RESULTS:
Performance on ANAM was compared with results of a consecutively administered, 2-hour battery of traditional neuropsychological tests and the Beck Depression Inventory II (BDI-II). Individual ANAM cognitive test scores were significantly correlated with most neuropsychological tests, particularly those measuring psychomotor processing speed and executive functioning. Using logistic regression, ANAM cognitive subtests successfully predicted individuals with SLE who had probable versus no impairment after controlling for premorbid levels of cognitive ability. Sensitivity of group classification was 76.2% and specificity was 82.8%, with 80% correct classification overall. ANAM's ability to predict neuropsychological functioning remained even after controlling for subjective reports of depressed mood and current sleepiness. Further, the ANAM mood scale was significantly correlated with the BDI-II (r = 0.67, P < 0.001), indicating its potential future use as a screening tool for emotional distress.

CONCLUSION:
ANAM shows promise as a time- and cost-efficient tool for screening and monitoring cognitive and emotional functioning in SLE, and can indicate when a more thorough neuropsychological investigation is warranted.

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Author information

Author/s: Roebuck-Spencer, Tresa M (TM); Yarboro, Cheryl (C); Nowak, Miroslawa (M); Takada, Kazuki (K); Jacobs, Geneva (G); Lapteva, Larissa (L); Weickert, Thomas (T); Volpe, Bruce (B); Diamond, Betty (B); Illei, Gabor (G); Bleiberg, Joseph (J);

Affiliation: Center for Cognitive Neuroscience, National Rehabilitation Hospital, Washington, DC 20010, USA. Tresa.roebuck(-atsign-)medstar.net

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Arthritis and rheumatism (Arthritis Rheum), published in United States. (Language: eng)

Reference: 2006-Jun; vol 55 (issue 3) : pp 434-41

Dates: Created 2006/06/19; Completed 2006/07/06; Revised 2006/11/15;

PMID: 16739211, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Affect - physiology
Affective Symptoms - diagnosis; etiology
Cognition Disorders - diagnosis; etiology
Diagnosis, Computer-Assisted - methods
Disorders of Excessive Somnolence - diagnosis; etiology

Female
Humans
Lupus Erythematosus, Systemic - complications; diagnosis; psychology
Male
Neuropsychological Tests
Predictive Value of Tests

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