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Updated: May 4, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Value of questionnaire-based screening as a proxy for neurocognitive testing in childhood-onset systemic lupus
Insights
Questionnaires assessing cognitive and behavioral symptoms are not sufficient to screen for neurocognitive dysfunction in childhood-onset systemic lupus erythematosus (cSLE). Formal neurocognitive testing remains essential for accurate assessment in pediatric patients.
Area of Science:
- Pediatric Rheumatology
- Neuropsychology
- Child Neurology
Background:
- Childhood-onset systemic lupus erythematosus (cSLE) can impact cognitive function.
- Neurocognitive dysfunction is a significant concern in pediatric patients with cSLE.
- Screening tools for neurocognitive impairment in cSLE require validation.
Purpose of the Study:
- To evaluate the effectiveness of questionnaire-based assessments for screening neurocognitive dysfunction in cSLE.
- To compare questionnaire data with formal neurocognitive testing (FNCT) in children with cSLE.
- To determine if subjective and parent-reported measures can replace objective cognitive testing.
Main Methods:
- Forty children with cSLE and 24 healthy controls (ages 10–16) were enrolled.
- Formal neurocognitive testing (FNCT) assessed attention, working memory, psychomotor speed, and visuoconstructional ability.
- Patients completed the SAND-C questionnaire; parents completed the Child Behavioral Checklist and BRIEF.
Main Results:
- Brief and SAND-C scores showed modest correlations with FNCT performance.
- Questionnaire ratings did not differentiate cognitive ability levels identified by FNCT.
- Self- and parent-reported measures did not adequately screen for neurocognitive impairment.
Conclusions:
- Questionnaire-based assessments are not a suitable replacement for FNCT in screening for neurocognitive impairment in pediatric cSLE.
- These questionnaires may offer complementary information for clinical follow-up.
- Formal neurocognitive testing remains the gold standard for assessing cognitive deficits in cSLE.
Objective:
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).
Methods:
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.
Results:
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.
Conclusion:
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.
