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

• Published in: Arthritis and rheumatism 2006-06, Vol.55 (3), p.434-441
• Main Authors: Roebuck‐spencer, Tresa M., Yarboro, Cheryl, Nowak, Miroslawa, Takada, Kazuki, Jacobs, Geneva, Lapteva, Larissa, Weickert, Thomas, Volpe, Bruce, Diamond, Betty, Illei, Gabor, Bleiberg, Joseph
• Format: Article
• Language: English
• Subjects: Adult; Affect - physiology; Affective Symptoms - diagnosis; Affective Symptoms - etiology; ANAM; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognitive functioning; Diagnosis, Computer-Assisted - methods; Diseases of the osteoarticular system; Disorders of Excessive Somnolence - diagnosis; Disorders of Excessive Somnolence - etiology; Female; Humans; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - psychology; Male; Medical sciences; Neuropsychological testing; Neuropsychological Tests; Predictive Value of Tests; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
• ISSN: 0004-3591; 0893-7524; 1529-0131; 1529-0123
• DOI: 10.1002/art.21992

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.