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Impaired memory and learning abilities in patients with Systemic Lupus Erythematosus as measured by the Rey-Auditory Verbal Learning Test
  1. Daphna Paran (parand{at}netvision.net.il)
  1. Dept of Rheumatology, Tel-Aviv Medical Center, Israel
    1. Irena Litinsky
    1. Dept of Rheumatology, Tel-Aviv Medical Center, Israel
      1. Irit Shapira-Lichter
      1. Wohl Institute for Advanced Imaging, Tel-Aviv Medical Center, Israel
        1. Shaul Navon
        1. Dept of Rheumatology, Tel-Aviv Medical Center, Israel
          1. Talma Hendler
          1. Wohl Institute for Advanced Imaging, Tel-Aviv Medical Center, Israel
            1. Dan Caspi
            1. Dept of Rheumatology, Tel-Aviv Medical Center, Israel
              1. Eli Vakil
              1. 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.

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