Assessment of Cognitive Function in Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Multiple Sclerosis by Computerized Neuropsychological Tests
Assessment of Cognitive Function in Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Multiple Sclerosis by Computerized Neuropsychological Tests
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DOI：
10.1002/art.27404
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发表时间：
2010-05-01
影响因子：
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通讯作者：
Fisk, John D.
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文献类型：
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作者：
Hanly, John G.;Omisade, Antonina;Fisk, John D.
目标。计算机化神经心理测试有助于系统性红斑狼疮(SLE)患者认知功能障碍的筛查。本研究采用自动神经心理评估量表(ANAM)对系统性红斑狼疮(SLE)、类风湿性关节炎(RA)和多发性硬化症(MS)患者与健康对照组进行比较。系统性红斑狼疮(SLE)68例，类风湿关节炎(RA)33例，多发性硬化症(MS)20例，与健康对照组(29例)比较。使用吞吐量(TP)、反向效率(IE)和调整后的反向效率分数来检验8个ANAM分测验的认知操作效率。后者对较高的认知功能更敏感，因为它根据简单反应时间对表现的影响进行了调整。采用O‘Brien广义最小二乘检验对结果进行分析。对照组受试者在认知表现上最有效率。MS患者的总体有效率最低(根据TP和IE评分)，并且低于SLE患者(P=0.01)和RA患者(P<；0.01)，这两个患者没有差异。调整后的IE评分在SLE患者、RA患者和对照组之间相似，反映了简单反应时间对认知表现的影响。因此，50%的系统性红斑狼疮患者、61%的类风湿性关节炎患者和75%的多发性硬化症患者在>；=1 ANAM亚测试中表现受损。只有9%的类风湿性关节炎患者和11%的系统性红斑狼疮患者在>；=4次测验中表现受损，而20%的多发性硬化症患者是如此。ANAM对认知障碍很敏感。虽然这种计算机化测试可能是一种有价值的筛查工具，但我们的结果强调，作为SLE患者高级认知功能损害的可靠指标，表现减慢缺乏特异性。
Objective. Computerized neuropsychological testing may facilitate screening for cognitive impairment in systemic lupus erythematosus (SLE). This study was undertaken to compare patients with SLE, patients with rheumatoid arthritis (RA), and patients with multiple sclerosis (MS) with healthy controls using the Automated Neuropsychological Assessment Metrics (ANAM).Methods. Patients with SLE (n = 68), RA (n = 33), and MS (n = 20) were compared with healthy controls (n = 29). Efficiency of cognitive performance on 8 ANAM subtests was examined using throughput (TP), inverse efficiency (IE), and adjusted IE scores. The latter is more sensitive to higher cognitive functions because it adjusts for the impact of simple reaction time on performance. The results were analyzed using O'Brien's generalized least squares test.Results. Control subjects were the most efficient in cognitive performance. MS patients were least efficient overall (as assessed by TP and IE scores) and were less efficient than both SLE patients (P = 0.01) and RA patients (P < 0.01), who did not differ. Adjusted IE scores were similar between SLE patients, RA patients, and controls, reflecting the impact of simple reaction time on cognitive performance. Thus, 50% of SLE patients, 61% of RA patients, and 75% of MS patients had impaired performance on >= 1 ANAM subtest. Only 9% of RA patients and 11% of SLE patients had impaired performance on >= 4 subtests, whereas this was true for 20% of MS patients.Conclusion. ANAM is sensitive to cognitive impairment. While such computerized testing may be a valuable screening tool, our results emphasize the lack of specificity of slowed performance as a reliable indicator of impairment of higher cognitive function in SLE patients.