Neuropsychological Testing for Lupus and Depression

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DESCRIPTION (provided by applicant): Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which is characterized by multi-system involvement and diverse manifestations. A large fraction of patients with SLE demonstrate organic psychiatric and neurologic disorders indicating central nervous system (CNS) involvement and the prevalence of cognitive abnormalities is approximatley 50 percent. An ad hoc multidisciplinary Committee of 35 members was convened by The American College of Rheumatology Research Committee in April of 1997 for the purpose of developing standard nomenclature for neuropsychiatric SLE and proposed a standard battery of neuropsychological tests for SLE This study was designed to provide validity and reliability for this proposed short battery. Pilot data by this investigator has suggested that diagnostic categories are complicated by a large proportion of systemic lupus erythematosus (SLE) patients being categorized as CNS-SLE (Central Nervous System-SLE) due to symptoms of depression. We see these preliminary data as providing controversy and ultimately opportunity to better classify and understand the cognitive effects of depression in SLE. Information regarding the sensitivity and specificity of this type of battery will justify the use of a short battery for clinical evaluation in SLE, in SLE patients with depression, and potentially in patients with depression only. Specific Aims are 1) To compare the frequency of neuropsychological impairment in CNS-SLE, CNS-SLE-depressed, non-CNSSLE and normal controls using the proposed American College of Rheumatology (ACR) Repeatable Neuropsychological Battery for SLE (ACR-RNB-SLE); 2) To examine the frequency of SLE patients impaired on the ACR-RNB-SLE compared to a larger comprehensive battery; 3) To determine reliability of the proposed ACR-RNB-SLE; 4) To examine associations between performance on the ACR-RNB-SLE and proposed measures of depression, fatigue and pain; and 5) To compare cognitive performance of the CNS-SLE-depressed group to a control group of depressed-only patients.