Measures of Cognition in Rheumatic Diseases

Yuen, Kimberley; Bingham, Kathleen; Tayer-Shifman, Oshrat E; Touma, Zahi

doi:10.1002/acr.24364

Cited by 6 publications

(9 citation statements)

References 82 publications

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“…(3) lack of validated diagnostic biomarkers of CD; (4) the heterogeneous study populations of SLE patients in observational studies [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, CD, defined as a significant deficit in any of the cognitive domains of simple or complex attention, reasoning, executive skills, memory, visual-spatial processing, language and psychomotor speed [ 2 ], afflicts 3% to 88% of SLE patients [ 3 – 6 ]. Reasons on the wide variation in the reported prevalence of CD in SLE include: (1) lack of consensus in screening tools for the identification of CD in SLE—the current gold standard is the American College of Rheumatology (ACR) battery, which is limited by cost and time burden, making it more feasible for use in research rather than clinical settings; (2) difficulty in attributing CD to SLE; (3) lack of validated diagnostic biomarkers of CD; (4) the heterogeneous study populations of SLE patients in observational studies [ 7 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Simpler tools to detect CD in SLE have been validated. These include the Automated Neuropsychological Assessment Metrics (ANAM), Montreal Cognitive Assessment (MoCA), Hopkins Verbal Learning Test-Revised (HVLT-R) and Controlled Oral Word Association Test (COWAT), all of which have been shown to facilitate rapid and efficient screening [ 12 , 97 ]. The ANAM is a 30–45-min computerized battery of tests developed by the US military to assess the effects of combat on cognitive function.…”

Section: Introductionmentioning

confidence: 99%

“…The HVLT-R and COWAT are independent neuropsychological tests that assess specific domains (verbal learning and memory and verbal fluency, respectively) and are also a part of the neuropsychological battery [ 12 ]. They have both been used broadly as screening tools for CD in SLE and other clinical populations because of their brevity and accessibility.…”

Section: Introductionmentioning

confidence: 99%

“…This test consists of three trials for which participants generate words beginning with specific letters under timed conditions. Caution though should be taken when administering the COWAT as a stand-alone tool for CD assessment as the results are highly influenced by education and age and only valid for participants fluent in the language of administration [ 12 ]. The ANAM, MoCA, HVLT-R, and COWAT have psychometric evidence for reliability, validity and responsiveness generally and in rheumatic disease (including SLE).…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Dysfunction in Systemic Lupus Erythematosus: Immunopathology, Clinical Manifestations, Neuroimaging and Management

et al. 2021

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Cognitive dysfunction (CD) is a common yet often clinically subtle manifestation that considerably impacts the health-related quality of life in patients with systemic lupus erythaematosus (SLE). Given the inconsistencies in CD assessment and challenges in its attribution to SLE, the reported prevalence of CD differs widely, ranging from 3 to 88%. The clinical presentation of CD in SLE is non-specific and may manifest concurrently with overt neuropsychiatric illness such as psychosis or mood disorders or as isolated impairment of attention, working memory, executive dysfunction or processing speed. Despite the lack of standardized and sensitive neuropsychological tests and validated diagnostic biomarkers of CD in SLE, significant progress has been made in identifying pathogenic neural pathways and neuroimaging.Furthermore, several autoantibodies, cytokines, pro-inflammatory mediators and metabolic factors have been implicated in the pathogenesis of CD in SLE. Abrogation of the integrity of the blood-brain barrier (BBB) and ensuing autoantibody-mediated neurotoxicity, complement and microglial activation remains the widely accepted mechanism of SLE-related CD. Although several functional neuroimaging modalities have consistently demonstrated abnormalities that correlate with CD in SLE patients, a consensus remains to be reached as to their clinical utility in diagnosing CD. Given the multifactorial aetiology of CD, a multi-domain interventional approach that addresses the risk factors and disease mechanisms of CD in a concurrent fashion is the favourable therapeutic direction. While cognitive rehabilitation and exercise training remain important, specific pharmacological agents that target microglial activation and maintain the BBB integrity are potential candidates for the treatment of SLE-related CD.

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“…(3) lack of validated diagnostic biomarkers of CD; (4) the heterogeneous study populations of SLE patients in observational studies [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cognitive Dysfunction in Systemic Lupus Erythematosus: Immunopathology, Clinical Manifestations, Neuroimaging and Management

et al. 2021

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Intraindividual Change in Cognitive Function Among Adults With Systemic Lupus Erythematosus: A Markov Analysis Over 7 Years

Perera

Cook

Lee

et al. 2023

ACR Open Rheumatology

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Objective. Cognitive impairment is prevalent in systemic lupus erythematosus (SLE). There remain gaps in understanding cognition and SLE longitudinally. We studied intraindividual change in cognition in SLE over time.Methods. Data were from the University of California, San Francisco Lupus Outcome Study, which included 1281 adults with SLE. The Hopkins Verbal Learning Test-Revised (HVLT-R) and the Controlled Oral Word Association Test (COWAT) were administered annually over 7 years. A two-state Markov analysis was used to model transition intensities for probabilities of change in cognition. Logistic regression examined the association between clinical variables and cognitive change.Results. Minimal transition between cognitive states was observed in the Markov analysis. Using the COWAT, higher levels of self-reported depression were associated with decreased likelihood of cognitive improvement (Relative Risk [RR]: 0.98; 95% confidence interval [CI]: 0.96-0.99), and higher self-reported disease severity was associated with cognitive decline (

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Cognitive dysfunction in systemic lupus erythematosus: how do we advance our understanding?

Raghunath

Hanly

Morand

et al. 2022

The Lancet Rheumatology

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Measures of Cognition in Rheumatic Diseases

Cited by 6 publications

References 82 publications

Cognitive Dysfunction in Systemic Lupus Erythematosus: Immunopathology, Clinical Manifestations, Neuroimaging and Management

Cognitive Dysfunction in Systemic Lupus Erythematosus: Immunopathology, Clinical Manifestations, Neuroimaging and Management

Intraindividual Change in Cognitive Function Among Adults With Systemic Lupus Erythematosus: A Markov Analysis Over 7 Years

Cognitive dysfunction in systemic lupus erythematosus: how do we advance our understanding?

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