Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T17:43:30.341Z Has data issue: false hasContentIssue false
  • English
  • Français

Working memory and processing speed deficits in systemic lupus erythematosus as measured by the paced auditory serial addition test

Published online by Cambridge University Press:  06 February 2004

JANET L. SHUCARD ,
JOY PARRISH ,
DAVID W. SHUCARD ,
DANIELLE C. McCABE ,
RALPH H.B. BENEDICT  and
JULIAN AMBRUS
JANET L. SHUCARD
Affiliation:
Department of Neurology, Division of Developmental and Behavioral Neurosciences, State University of New York at Buffalo School of Medicine and Biomedical Sciences
JOY PARRISH
Affiliation:
Department of Neurology, Division of Developmental and Behavioral Neurosciences, State University of New York at Buffalo School of Medicine and Biomedical Sciences
DAVID W. SHUCARD
Affiliation:
Department of Neurology, Division of Developmental and Behavioral Neurosciences, State University of New York at Buffalo School of Medicine and Biomedical Sciences
DANIELLE C. McCABE
Affiliation:
Department of Neurology, Division of Developmental and Behavioral Neurosciences, State University of New York at Buffalo School of Medicine and Biomedical Sciences
RALPH H.B. BENEDICT
Affiliation:
Department of Neurology, Division of Developmental and Behavioral Neurosciences, State University of New York at Buffalo School of Medicine and Biomedical Sciences
JULIAN AMBRUS
Affiliation:
Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences
Get access Rights & Permissions [Opens in a new window]

Abstract

As many as 66% of systemic lupus erythematosus (SLE) patients have been reported to have cognitive deficits. These deficits are often associated with information processing speed and working memory. Similarly, processing speed and working memory impairments are the hallmark of cognitive dysfunction in multiple sclerosis (MS). The Paced Auditory Serial Addition Test (PASAT) places high demands on processing speed and working memory. Fisk and Archibald, however, demonstrated that the total score of the PASAT does not accurately reflect impairments in these cognitive processes. They found that MS patients used a chunking strategy to obtain correct responses and reduce the cognitive demands of the task. In the present study, PASAT performance was examined for 45 SLE patients and 27 controls using alternative scoring procedures. Although the total number of correct responses did not differ between SLE and controls at the 2.4 or 2.0 s presentation rates, SLE patients had fewer dyads (correct consecutive responses) than controls at the faster rate, and more chunking responses than controls at both rates. Disease activity, disease duration, depression, fatigue, and corticosteroids could not account for these differences. The findings suggest that SLE patients, like MS patients, chunk responses more often than controls, and that this scoring procedure may better reflect the working memory and processing speed deficits present in SLE. (JINS, 2004, 10, 35–45.)

Keywords

Autoimmune diseaseMultiple sclerosisSubcortical dementiaCognitive impairmentNeuropsychiatric SLE
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 10 , Issue 1 , January 2004 , pp. 35 - 45
Copyright
© 2004 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

ACR Ad Hoc Committee on Neuropsychiatric Lupus Nomenclature. (1999). The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis and Rheumatism, 42, 599–608.Google Scholar
Ainiala, H., Loukkola, J., Peltola, J., Korpela, M., & Hietaharju, A. (2001). The prevalence of neuropsychiatric syndromes on systemic lupus erythematosus. Neurology, 57, 496–500.CrossRefGoogle Scholar
Beatty, W.W. & Scott, J.G. (1993). Issues and developments in the neuropsychological assessment of patients with multiple sclerosis. Journal of Neurologic Rehabilitation, 7, 87–97.Google Scholar
Beck, A.T. (1987). Beck Depression Inventory: Manual. San Antonio, TX: The Psychological Corporation.
Brandt, J., Folstein, S.E., & Folstein, M.F. (1988). Differential cognitive impairment in Alzheimer's disease and Huntington's disease. Annals of Neurology, 23, 555–561.Google Scholar
Breitbach, S.A., Alexander, R.W., Daltroy, L.H., Liang, M.H., Boll, T.J., Karlson, E.W., Partridge, A.J., Roberts, W.N., Stern, S.H., Wacholtz, M.C., & Straaton, K.V. (1998). Determinants of cognitive performance in systemic lupus erythematosus. Journal of Clinical and Experimental Neuropsychology, 20, 157–166.CrossRefGoogle Scholar
Butman, J.A. & Frank, J.A. (2000). Overview of imaging in multiple sclerosis and white matter diseases. Neuroimaging Clinics of North America, 10, 669–687.Google Scholar
Carbotte, R.M., Denburg, S.D., & Denburg, J.A. (1986). Prevalence of cognitive impairment in systemic lupus erythematosus. Journal of Nervous and Mental Disease, 174, 357–364.CrossRefGoogle Scholar
Chinn, R.J.S., Wilkinson, I.D., Hall-Cragge, M.A., Paley, M.N.J., Shortall, E., Carter, S., Kendall, B.E., Isenberg, D.A., Newman, S.P., & Harrison, M.J.G. (1997). Magnetic resonance imaging of the brain and cerebral proton spectroscopy in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 40, 36–46.Google Scholar
Cummings, J. (1990). Introduction. In J.L. Cummings (Ed.), Subcortical dementia, (pp. 3–16). New York: Oxford University Press.
DeLuca, J., Johnson, S.K., & Natelson, B.H. (1993). Information processing efficiency in chronic fatigue syndrome, and multiple sclerosis. Archives of Neurology, 50, 301–304.CrossRefGoogle Scholar
Denburg, S.D., Carbotte, R.M., & Denburg, J.A. (1987). Cognitive impairment in systemic lupus erythematosus: A neuropsychological study of individual and group deficits. Journal of Clinical and Experimental Neuropsychology, 9, 323–339.CrossRefGoogle Scholar
Denburg, S.D., Carbotte, R.M., & Denburg, J.A. (1992). Cognitive deficit in nonneuropsychiatric SLE (fact or fiction?). Arthritis and Rheumatism, 35 (Suppl.), s208.Google Scholar
Denburg, S.D., Carbotte, R.M., & Denburg, J.A. (1994). Corticosteroids and neuropsychological functioning in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 37, 1311–1320.Google Scholar
Denburg, S.D., Carbotte, R.M., Ginsberg, J.S., & Denburg, J.A. (1997). The relationship of antiphospholipid antibodies to cognitive function in patients with systemic lupus erythematosus. Journal of the International Neuropsychological Society, 3, 377–386.Google Scholar
D'Esposito, M., Onishi, K., Thompson, H., Robinson, K., Armstrong, C., & Grossman, M. (1996). Working memory impairment in multiple sclerosis: Evidence from dual-task paradigm. Neuropsychology, 10, 51–56.Google Scholar
Diamond, B.J., DeLuca, J., Kim, H., & Kelley, S.M. (1997). The question of disproportional impairments in visual and auditory information processing in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 19, 34–42.CrossRefGoogle Scholar
Fisk, J.D., Eastwood, B., Sherwood, G., & Hanly, J.G. (1993). Patterns of cognitive impairment in patients with systemic lupus erythematosus. British Journal of Rheumatology, 32, 458–462.CrossRefGoogle Scholar
Fisk, J.D. & Archibald, C.J. (2001). Limitations of the Paced Auditory Serial Addition Test as a measure of working memory in patients with multiple sclerosis. Journal of the International Neuropsychological Society, 7, 363–372.CrossRefGoogle Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Glanz, B.I., Slonim, D., Urowitz, M.B., Gladman, D.D., Gough, J., & MacKinnon, A. (1997). Pattern of neuropsychologic dysfunction in inactive systemic lupus erythematosus. Neuropsychiatry, Neuropsychology and Behavioral Neurology, 10, 232–238.Google Scholar
Gonzales, C.F., Swirsky-Sacchetti, R., Mitchell, D., Lublin, F.D., Knobler, R.L., & Erlich, S.M. (1994). Distributional patterns of multiple sclerosis brain lesions. Journal of Neuroimaging, 4, 188–195.Google Scholar
Gonzalez-Crespo, M.R., Blanco, F.J., Ramos, A., Ciruelo, E., Mateo, I., Lopez Pino, M.A., & Gomez-Reino, J.J. (1995). Magnetic resonance imaging of the brain in systemic lupus erythematosus. British Journal of Rheumatology, 34, 1055–1060.Google Scholar
Grafman, J., Rao, S.M., & Litvan, I. (1990). Disorders of memory. In S.M. Rao (Ed.), Neurobehavioral aspects of multiple sclerosis (pp. 102–117). New York: Oxford University Press.
Grant, I. & Heaton, R.K. (1990). Human immunodeficiency virus-type 1 (HIV-1) and the brain. Journal of Consulting and Clinical Psychology, 58, 22–30.CrossRefGoogle Scholar
Gronwall, D.M. (1977). Paced auditory serial addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373.Google Scholar
Hanly, J.G., Fisk, J.D., Sherwood, G., & Eastwood, B. (1994). Clinical course of cognitive dysfunction in systemic lupus erythematosus. Journal of Rheumatology, 21, 1825–1831.Google Scholar
Hanly, J.G., Fisk, J.D., Sherwood, G., Jones, E., Jones, J.V., & Eastwood, B. (1992). Cognitive impairment in patients with systemic lupus erythematosus. Journal of Rheumatology, 19, 562–567.Google Scholar
Hanly, J.G. & Liang, M.H. (1997). Cognitive disorders in systemic lupus erythematosus: Epidemiologic and clinical issues. Annals of the New York Academy of Sciences, 823, 60–68.CrossRefGoogle Scholar
Hay, E.M., Black, D., Huddy, A., Creed, F., Tomenson, B., Bernstein, R.M., & Holt, P.J. (1992). Psychiatric disorder and cognitive impairment in systemic lupus erythematosus. Arthritis and Rheumatism, 35, 411–416.CrossRefGoogle Scholar
Joels, M., Karten, Y., Hesen, W., & de Kloet, E.R. (1997). Corticosteroid effects on electrical properties of brain cells: Temporal aspects and role of antiglucocorticoids. Psychoneuroendocrinology, 22 (Suppl. 1), S81–S86.Google Scholar
Kao, C.H., Ho, Y.J., Lan, J.L., Changlai, S.P., Liao, K.K., & Chieng, P.U. (1999). Discrepancy between regional cerebral blood flow and glucose metabolism of the brain in systemic lupus erythematosus patients with normal brain magnetic resonance imaging findings. Arthritis and Rheumatism, 42, 61–68.3.0.CO;2-9>CrossRefGoogle Scholar
Kozora, E., Thompson, L.L., West, S.G., & Kotzin, B.L. (1996). Analysis of cognitive and psychological deficits in systemic lupus erythematosus patients without overt central nervous system disease. Arthritis and Rheumatism, 39, 2035–2045.CrossRefGoogle Scholar
Kozora, E., Laudenslager, M., Lemieux, A., & West, S.G. (2001). Inflammatory and hormonal measures predict neuropsychological functioning in systemic lupus erythematosus and rheumatoid arthritis patients. Journal of the International Neurospychological Society, 7, 745–754.CrossRefGoogle Scholar
Kutner, K.C., Busch, H.M., Mahmood, T., Racis, S.P., & Krey, P.R. (1988). Neuropsychological functioning in systemic lupus erythematosus. Neuropsychology, 2, 119–126.Google Scholar
Leritz, E., Brandt, J., Minor, M., Reis-Jensen, F., & Petri, M. (2000). “Subcortical” cognitive impairment in patients with systemic lupus erythematosus. Journal of the International Neuropsychological Society, 6, 821–825.CrossRefGoogle Scholar
Liang, M.H., Socher, S.A., Larson, M.G., & Schur, P.H. (1989). Reliability and validity of six systems for the clinical assessment of disease activity in Systemic Lupus Erythematosus. Arthritis and Rheumatism, 32, 1107–1118.CrossRefGoogle Scholar
Lin, W.Y., Wang, S.J., Yen, T.C., & Lan, J.L. (1997). Technetium-99m-HMPAO brain SPECT in systemic lupus erythematosus with CNS involvement. Journal of Nuclear Medicine, 38, 1112–1115.Google Scholar
Litvan, I., Grafman, J., Vendrell, P., & Martinez, J. (1988a). Slowed information processing in multiple sclerosis. Archives of Neurology, 45, 281–285.Google Scholar
Litvan, I., Grafman, J., Vendrell, P., Martinez, J.M., Junque, C., Vendrell, J.M., & Barraquer-Bordas, L. (1988b). Multiple memory deficits in patients with multiple sclerosis: Exploring the working memory system. Archives of Neurology, 45, 607–610.Google Scholar
Lupien, S.J. & McEwen, B.S. (1997). The acute effects of corticosteroids on cognition: Integration of animal and human model studies. Brain Research–Brain Research Reviews, 24, 1–27.Google Scholar
Raine, C.S. (1990). Neuropathology. In S.M. Rao (Ed.), Neurobehavioral aspects of multiple sclerosis (pp. 15–36). New York: Oxford University Press.
Rao, S.M. (Ed.). (1990). Neurobehavioral aspects of multiple sclerosis. New York: Oxford University Press.
Rao, S.M. (1996). White matter disease and dementia. Brain and Cognition, 31, 250–268.CrossRefGoogle Scholar
Rao, S.M., Grafman, J., Diguilio, D., Mittenberg, W., Bernardin, L., Leo, G.J., Luchetta, T., & Univerzagt, F. (1993). Memory dysfunction in multiple sclerosis: Its relation to working memory, semantic encoding and implicit learning. Neuropsychology, 7, 364–374.CrossRefGoogle Scholar
Ruchkin, D.S., Grafman, J., Krauss, G.L., Johnson, R., Jr., Canoune, H., & Ritter, W. (1994). Event-related potential evidence for a verbal working memory deficit in multiple sclerosis. Brain, 117, 289–305.CrossRefGoogle Scholar
Sibley, W.A. (1990). The diagnosis and course of multiple sclerosis. In S.M. Rao (Ed.), Neurobehavioral aspects of multiple sclerosis (pp. 5–14). New York: Oxford University Press.
Skeel, R.L., Johnstone, B., Yangco, D.T., Jr., Walker, S.E., & Komatireddy, G.R. (2000). Neuropsychological deficit profiles in systemic lupus erythematosus. Applied Neuropsychology, 7, 96–101.Google Scholar
Snyder, P.J., Aniskiewicz, A.S., & Snyder, A.M. (1993). Quantitative MRI correlates and diagnostic utility of multi-modal measures of executive control in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 15, 18.Google Scholar
Snyder, P.J. & Cappelleri, J.C. (2001). Information processing speed deficits may be better correlated with the extent of white matter sclerotic lesions in Multiple Sclerosis than previously suspected. Brain and Cognition, 46, 279–284.CrossRefGoogle Scholar
Snyder, P.J., Cappelleri, J.C., Archibald, C.J., & Fisk, J.D. (2001). Improved detection of differential information-processing speed deficits between two disease-course types of Multiple Sclerosis. Neuropsychology, 15, 617–625.CrossRefGoogle Scholar
Stoppe, G., Wildhagen, K., Seidel, J.W., Meyer, G.J., Schober, O., Heintz, P., Kunkel., H., Deicher, H., & Hundeshagen, H. (1990). Positron emission tomography in neuropsychiatric lupus erythematosus. Neurology, 40, 304–308.CrossRefGoogle Scholar
Spreen, O. & Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.
Swirsky-Sacchetti, T., Mitchell, D.R., Seward, J., Gonzales, C., Lublin, F., Knobler, R., & Field, H.L. (1992). Neuropsychological and structural brain lesions in multiple sclerosis: A regional analysis. Neurology, 42, 1291–1295.CrossRefGoogle Scholar
Tan, E.M., Cohen, A.S., Fries, J.F., Massi, A.T., McShane, D.J., & Rothfield, N.F. (1982). The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis and Rheumatism, 25, 1271–1277.Google Scholar
Wechsler, D. (1997). Wechsler Memory Scale–Third Edition administration and scoring manual. San Antonio, TX: The Psychological Corporation.
Weiner, S.M., Otte, A., Schumacher, M., Klein, R., Gutfleisch, J., Brink, I., Otto, P., Nitzsche, E.U., Moser, E., & Peter, H.H. (2000). Diagnosis and monitoring of central nervous system involvement in systemic lupus erythematosus: Value of F-18 fluorodeoxyglucose PET. Annals of Rheumatic Diseases, 59, 377–385.CrossRefGoogle Scholar
Wekking, E.M., Nossent, J.C., Van Dam, A.P., & Swaak, A.J. (1991). Cognitive and emotional disturbances in systemic lupus erythematosus. Psychotherapy and Psychosomatics, 55, 126–131.CrossRefGoogle Scholar
West, S.G., Emlen, W., Wener, M.H., & Kotzin, B.L. (1995). Neuropsychiatric lupus erythematosus: A 10 year prospective study on the value of diagnostic tests. American Journal of Medicine, 99, 153–163.CrossRefGoogle Scholar
Wolkowitz, O.M., Reus, V.I., Canick, J., Levin, B., & Lupien, S. (1997). Glucocorticoid medication, memory and steroid psychosis in medical illness. Annals of the New York Academy of Sciences, 823, 81–96.Google Scholar