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Cognitive Function in a Systemic Lupus Erythematosus Inception Cohort
MICHELLE PETRI, MOHAMMAD NAQIBUDDIN, KATHRYN A. CARSON, MARGARET SAMPEDRO, DANIEL J. WALLACE, MICHAEL H. WEISMAN, STEPHEN L. HOLLIDAY, PATRICIA A. PADILLA, and ROBIN L. BREY
ABSTRACT. Methods. The Automated Neuropsychological Assessment Metrics (ANAM), a repeatable computerized cognitive battery assessing cognitive processing speed and efficiency, was administered to 111 recently diagnosed SLE patients and 79 normal controls. Throughput scores on ANAM subtests were compared using linear regression. Results. After adjusting for age, gender, ethnicity, and education, SLE patients scored significantly lower than controls on throughput measures of 4 ANAM subtests: code substitution immediate recall (p = 0.02), continuous performance (p = 0.02), matching to sample (p = 0.02), and Sternberg subtest (p = 0.0002). Conclusions. Recently diagnosed SLE patients performed significantly worse than normal controls on 4 of 9 ANAM subtests. ANAM subtests of cognitive efficiency requiring sustained attention/vigilance, visuospatial span of attention/working memory, and simple reaction time showed the greatest impairment. These cognitive deficits were particularly striking, because the SLE patients in this sample were not selected for the presence of neuropsychiatric manifestations, had mild SLE-related disease/damage, and were recently diagnosed with SLE. This suggests that deficits in cognitive efficiency and sustained attention are present early in the course of SLE and in the absence of other significant neuropsychiatric manifestations. (First Release July 15 2008; J Rheumatol 2008;35:1776-81) Key Indexing Terms:
SYSTEMIC LUPUS ERYTHEMATOSUS From Johns Hopkins University, Baltimore, MD; Cedars-Sinai Medical Center/David Geffen School of Medicine at UCLA, Los Angeles, CA; South Texas Veterans Health Care System; and University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. The Brain CONECTIONS study is supported by NIH RO1 AR049125 and the Johns Hopkins University: General Clinical Research Center (Kathryn Carson is supported by M01 RR00052) and the University of Texas Health Science Center at San Antonio Frederic C. Bartter General Clinical Research Center (MO1-RR-01346). M. Petri, MD, MPH, Professor; M. Naqibuddin, MBBS, MPH, Johns Hopkins University; K.A. Carson, ScM, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University; M. Sampedro, Johns Hopkins University; D.J. Wallace, MD; M.H. Weisman, MD, Cedars-Sinai Medical Center/David Geffen School of Medicine at UCLA; S.L. Holliday, PhD, ABPP, Chief, Psychology Service, South Texas Veterans Health Care System; P. Padilla, Department of Medicine, Division of Neurology; R.L. Brey, MD, University of Texas Health Science Center at San Antonio. Address reprint requests to Dr. M. Petri, 1830 East Monument Street, Suite 7500, Baltimore, MD, 21205, USA. E-mail: mpetri@jhmi.edu Accepted for publication April 1, 2008. |
