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Value of Questionnaire-Based Screening as a Proxy for Neurocognitive Testing in Childhood-Onset Systemic Lupus Erythematosus†
Article first published online: 27 MAY 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 6, pages 943–948, June 2014
How to Cite
Vega-Fernandez, P., Zelko, F. A., Klein-Gitelman, M., Lee, J., Hummel, J., Nelson, S., Thomas, E. C., Ying, J., Beebe, D. W. and Brunner, H. I. (2014), Value of Questionnaire-Based Screening as a Proxy for Neurocognitive Testing in Childhood-Onset Systemic Lupus Erythematosus. Arthritis Care Res, 66: 943–948. doi: 10.1002/acr.22247
- Issue published online: 27 MAY 2014
- Article first published online: 27 MAY 2014
- Accepted manuscript online: 10 DEC 2013 02:32PM EST
- Manuscript Accepted: 26 NOV 2013
- Manuscript Received: 30 JUL 2013
- National Institute of Arthritis and Musculoskeletal and Skin Diseases Center of Clinical Research Award (NIAMS grant). Grant Number: P60-AR47784
- Institutional Clinical and Translational Science Award (NIH/National Center for Research Resources grant). Grant Number: 5UL1RR026314-03
To investigate the utility of questionnaire-based assessment of cognitive function and behavioral/emotional symptoms to screen for neurocognitive dysfunction in childhood-onset systemic lupus erythematosus (cSLE).
Forty children with cSLE and 24 healthy controls ages 10–16 years were enrolled. Formal neurocognitive testing (FNCT) was done to determine cognitive performance in 4 key areas that appear to be sensitive to the adverse effects of cSLE: attention, working memory, psychomotor speed, and visuoconstructional ability. Paper and pencil questionnaires sampling cognitive functioning and behavioral/emotional symptoms were also completed: the Subjective Awareness of Neuropsychological Deficits for Children (SAND-C) questionnaire by patients, and the Child Behavioral Checklist and the Behavior Rating Inventory of Executive Function (BRIEF) by parents.
Domain and summary scores of the BRIEF and SAND-C correlated modestly with participants' performance on FNCT. Questionnaire ratings did not discriminate subjects with different levels of cognitive ability as measured by FNCT.
Contrary to some reports in adults with SLE, self-administered questionnaires of cognitive functioning and parent ratings of executive functioning do not appear well suited to replace FNCT in screening for neurocognitive impairment of children and adolescents with cSLE. However, they may provide information that is complementary to FNCT and therefore play a useful role in clinical followup.