Petri Michelle, Naqibuddin Mohammad, Carson Kathryn A, Sampedro Margaret, Wallace Daniel J, Weisman Michael H, Holliday Stephen L, Padilla Patricia A, Brey Robin L
Johns Hopkins University, Baltimore, MD, USA.
J Rheumatol. 2008 Sep;35(9):1776-81. Epub 2008 Jul 15.
Measurable cognitive impairment occurs in 30-75% of patients with systemic lupus erythematosus (SLE). We compared cognitive functioning in recently-diagnosed SLE patients and normal controls.
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.
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).
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.
30%-75%的系统性红斑狼疮（SLE）患者存在可测量的认知障碍。我们比较了新诊断的SLE患者与正常对照者的认知功能。
对111例新诊断的SLE患者和79名正常对照者进行了自动神经心理评估指标（ANAM）测试，这是一种可重复的计算机化认知测试组合，用于评估认知处理速度和效率。使用线性回归比较ANAM子测试的通量分数。
在对年龄、性别、种族和教育程度进行调整后，SLE患者在ANAM的4个测试子项目的通量测量中得分显著低于对照组：代码替换即时回忆（p = 0.02）、连续作业测试（p = 0.02）、样本匹配（p = 0.02）和斯特恩伯格子测试（p = 0.0002）。
新诊断的SLE患者在9个ANAM子测试中的4个测试项目上的表现明显比正常对照者差。需要持续注意力/警觉性、视觉空间注意力跨度/工作记忆以及简单反应时间的认知效率ANAM子测试显示出最大的损伤。这些认知缺陷尤为显著，因为该样本中的SLE患者并非因存在神经精神表现而入选，患有轻度SLE相关疾病/损伤，且为新诊断的SLE患者。这表明在SLE病程早期，在没有其他明显神经精神表现的情况下，就存在认知效率和持续注意力的缺陷。
