RESEARCH - Impaired memory and learning abilities in patients with SLE as measured by the Rey-Auditory Verbal Learning Test

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Ann Rheum Dis. Published Online First: 1 July 2008. doi:10.1136/ard.2008.091538

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Extended Report

Impaired memory and learning abilities in patients with Systemic Lupus

Erythematosus as measured by the Rey-Auditory Verbal Learning Test

Daphna Paran 1*, Irena Litinsky 1, Irit Shapira-Lichter 2, Shaul Navon

1, Talma Hendler 2, Dan Caspi 1 and Eli Vakil 3

1 Dept of Rheumatology, Tel-Aviv Medical Center, Israel

2 Wohl Institute for Advanced Imaging, Tel-Aviv Medical Center, Israel

3 Department of Psychology and Gonda Multidisciplinary Brain Research

Center, Bar-Ilan University, Israel

Abstract

Objective: To assess and characterize verbal memory impairment in SLE

patients by the Rey-Auditory Verbal Learning Test (Rey-AVLT).

Methods: Forty consecutive, unselected SLE patients were evaluated

with the Rey-AVLT, a clinical and research tool for the study of

multiple learning and memory measures. All patients were assessed for

disease activity, damage, presence of antiphospholipid antibodies and

depression. Findings were compared to 40 healthy controls matched for

age, sex and education.

Results: The study group included 40 SLE patients (F/M- 37/3), median

age 33 yrs (range 20-59), median disease duration 8 yrs (range

0.3-32). Median disease activity measured by SLEDAI was 4 (range

0-16). Median damage measured by SLICC /ACR damage index score was 0

(range 0-4). Depression was detected in 16/40 patients. Several

aspects of the memory domain, as measured by the Rey-AVLT were

impaired in the SLE group, using Analysis of Variance with repeated

measures. The learning curve of SLE patients was significantly less

steep as compared to controls, (p=0.036), the rate of words omitted

from trial to trial was higher in the SLE group (p=0.034) and

retrieval was less efficient in SLE compared to controls ( p=0.004).

The significance of these findings was maintained after omitting

patients with stroke or depression.

Conclusion: Learning ability was impaired in SLE patients with a poor

and inefficient learning strategy as reflected by an impaired learning

curve, repeated omissions and impaired retrieval. This pattern of

memory deficit resembles that seen in patients with frontal lobe

damage and warrants further localizing brain studies.

http://ard.bmj.com/cgi/content/abstract/ard.2008.091538v1

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