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


CONCLUSIONS
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.
Roebuck-Spencer
Tresa M
TM
Center for Cognitive Neuroscience, National Rehabilitation Hospital, Washington, DC 20010, USA. Tresa.roebuck@medstar.net
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
D000328:Adult; D000339:Affect / Q000502:physiology; D000342:Affective Symptoms / Q000175:diagnosis* / Q000209:etiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests