Comparison of neuropsychological impairment and vocational outcomes in systemic lupus erythematosus and multiple sclerosis patients.

Systemic lupus erythematosus (SLE) and multiple sclerosis (MS) are chronic immunologic diseases that can cause cognitive dysfunction. MS is a central nervous system (CNS) disease characterized by demyelination and progressive brain atrophy. SLE is an autoimmune disease capable of damaging multiple organ systems, including the CNS. Cognitive disturbances are seen in both SLE and MS. The present study is concerned with understanding the similarities and differences between the cognitive profiles of SLE and MS as well as the relationship between cognitive impairment and vocational disability in these patients. We examined 47 SLE patients, 47 MS patients, and 44 healthy controls. The groups were well matched on demographics and the patient groups were also matched on disease duration and severity. Group comparisons revealed that generative verbal fluency and visual-spatial memory are more profoundly affected in MS than SLE; whereas depression, fatigue, and working memory deficits are similarly involved in both diseases. Logistic regression analysis revealed that executive function, in particular, was predictive of vocational outcomes in SLE and MS patients.

Validity of the California Verbal Learning Test-II in multiple sclerosis.

Multiple sclerosis (MS) is a disease of the central nervous system where roughly 50% of patients exhibit cognitive impairment. Episodic memory defects are particularly common in MS and the California Verbal Learning Test: 2nd Edition (CVLT-II) was recommended for assessment in MS in a recently published consensus position paper. We investigated the validity of the CVLT-II in 351 MS patients and 69 demographically matched normal controls. MS patients performed significantly more poorly on 18 of the 23 measures examined. In addition to a general memory factor, factor analysis revealed five distinct factors conforming to measures of consolidation, primary/recency effect, proactive interference, and learning asymptote. The external validity of the CVLT-II was also supported by logistic regression analysis, which separated employed from work-disabled MS patients. We conclude that the CVLT-II is a valid test in MS and provides a rich constellation of verbal memory measures.