Roebuck-Spencer Tresa M, Yarboro Cheryl, Nowak Miroslawa, Takada Kazuki, Jacobs Geneva, Lapteva Larissa, Weickert Thomas, Volpe Bruce, Diamond Betty, Illei Gabor, Bleiberg Joseph
Center for Cognitive Neuroscience, National Rehabilitation Hospital, Washington, DC 20010, USA.
Arthritis Rheum. 2006 Jun 15;55(3):434-41. doi: 10.1002/art.21992.
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.
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.
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.
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.
认知功能障碍和神经精神紊乱在系统性红斑狼疮（SLE）中很常见。本研究探讨了自动化神经心理评估指标（ANAM）预测SLE患者神经心理状态的能力，ANAM是一种计算机化认知测试组合，包括认知子测试、嗜睡评定量表和情绪量表。
对60名无明显神经精神症状的SLE患者进行ANAM测试，以确定其作为SLE认知功能障碍和情绪困扰筛查手段的有效性。
将ANAM测试结果与连续进行的2小时传统神经心理测试及贝克抑郁量表第二版（BDI-II）的结果进行比较。ANAM各个认知测试分数与大多数神经心理测试显著相关，尤其是那些测量心理运动处理速度和执行功能的测试。使用逻辑回归分析，在控制病前认知能力水平后，ANAM认知子测试成功预测了可能存在损伤与无损伤的SLE患者。组分类的敏感性为76.2%，特异性为82.8%，总体正确分类率为80%。即使在控制了抑郁情绪和当前嗜睡的主观报告后，ANAM预测神经心理功能的能力依然存在。此外，ANAM情绪量表与BDI-II显著相关（r = 0.67，P < 0.001），表明其未来有可能作为情绪困扰的筛查工具。
ANAM有望成为一种省时且经济高效的工具，用于筛查和监测SLE患者的认知和情绪功能，并能指明何时需要进行更全面的神经心理调查。
