Impact of inflammation on cognitive function in patients with highly inflammatory rheumatoid arthritis.

IF 5.1 2区 医学 Q1 RHEUMATOLOGY
Natalia Mena-Vázquez, Fernando Ortiz-Márquez, Teresa Ramírez-García, Pablo Cabezudo-García, Aimara García-Studer, Arkaitz Mucientes-Ruiz, Jose Manuel Lisbona-Montañez, Paula Borregón-Garrido, Patricia Ruiz-Limón, Rocío Redondo-Rodríguez, Sara Manrique-Arija, Laura Cano-García, Pedro J Serrano-Castro, Antonio Fernández-Nebro
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Abstract

Objective: To evaluate cognitive function in patients with rheumatoid arthritis (RA) and inflammatory activity.

Patients and methods: We performed a cross-sectional study of a cohort of patients with RA initiating their first biological treatment due to moderate-to-high inflammation and a healthy control group (no inflammatory diseases) matched for age, sex and educational level. All participants underwent a comprehensive neuropsychological assessment, with cognitive impairment defined as a Montreal Cognitive Assessment (MoCA) score<26. Additional assessments included various cognitive tests (STROOP, forward and backward digit spans), anxiety and depression scales (Hospital Anxiety and Depression Scale), quality of life measures (Quality of Life-Rheumatoid Arthritis) and average inflammatory activity according to the 28-joint Disease Activity Score (DAS28)-C-reactive protein (CRP) into high activity (DAS28≥3.2) and low activity (DAS28<3.2) groups, also CRP levels and interleukin 6 (IL-6) levels were measured using an ELISA.

Results: The study population comprised 140 participants, 70 patients with RA and 70 controls. Patients more frequently experienced cognitive impairment than controls (60% vs 40%; p=0.019) and had lower mean (SD) values in the MoCA (23.6 (3.9) vs 25.1 (3.4); p=0.019. As for subtests of the MoCA, involvement was more marked in patients than in controls for the visuospatial-executive (p=0.030), memory (p=0.026) and abstraction (p=0.039) domains. Additionally, patients scored lower on executive function, as assessed by the backward digit span test (4.0 (1.7) vs 4.7 (1.9); p=0.039). Cognitive impairment is associated with age and a lower educational level in the general population, and among patients with RA with educational level, obesity and average inflammatory activity (DAS28, CRP, and IL-6).

Conclusions: Patients with RA with high inflammatory activity are more susceptible to cognitive impairment, which specifically affects the domains of visuospatial, memory, abstraction and executive function.

炎症对高度炎症性类风湿性关节炎患者认知功能的影响。
目的:评估类风湿性关节炎(RA)和炎症活动患者的认知功能:评估类风湿性关节炎(RA)患者的认知功能和炎症活动:我们对一组因中度至高度炎症而开始首次生物治疗的类风湿性关节炎患者和一组年龄、性别和教育程度相匹配的健康对照组(无炎症性疾病)进行了横断面研究。所有参与者都接受了全面的神经心理学评估,认知障碍的定义是蒙特利尔认知评估(MoCA)得分:研究对象共 140 人,其中 70 人为 RA 患者,70 人为对照组。与对照组相比,患者更常出现认知障碍(60% 对 40%;P=0.019),MoCA 的平均(标清)值也更低(23.6 (3.9) 对 25.1 (3.4);P=0.019)。至于 MoCA 的子测试,患者在视觉空间执行(p=0.030)、记忆(p=0.026)和抽象(p=0.039)领域的受累程度比对照组更明显。此外,通过后向数字跨度测试评估,患者的执行功能得分较低(4.0 (1.7) vs 4.7 (1.9); p=0.039)。在普通人群中,认知障碍与年龄和较低的教育水平有关,而在RA患者中,认知障碍与教育水平、肥胖和平均炎症活动(DAS28、CRP和IL-6)有关:结论:高炎症活动度的RA患者更容易出现认知障碍,尤其影响视觉空间、记忆、抽象和执行功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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