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[Cognitive disorders in Behçet's disease]
P S Ovcharov1, T A Lisitsyna1, D Yu Veltishchev2
1Nasonova Research Institute of Rheumatology, Moscow, Russia.
Insights
Cognitive disorders are common in Behçet
Area of Science:
- Neuroscience
- Rheumatology
- Psychiatry
Background:
- Behçet's Disease (BD) is a multisystemic inflammatory disorder.
- Cognitive disorders (CD) and mental health issues are increasingly recognized in BD patients.
- Understanding the prevalence and correlations of CD in BD is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of cognitive disorders (CD) in Behçet's Disease (BD) patients.
- To investigate the clinical and pathogenetic correlations of CD in BD.
Main Methods:
- 106 BD patients were assessed using psychiatric interviews and validated scales (MADRS, HAM-A).
- Cognitive functions (memory, attention, logic) were evaluated using clinical/psychological methods.
- Brain MRI was performed on a subset of patients to identify neurological changes.
Main Results:
- Cognitive disorders (mild to moderate) were diagnosed in 77.4% of BD patients.
- Anxiety-depressive disorders were prevalent in 76.4% of BD patients, significantly higher in those with CD.
- Patients with CD were older and showed a higher frequency of subcortical white matter lesions on MRI.
Conclusions:
- Cognitive disorders are a characteristic feature in the majority of BD patients.
- CD in BD are associated with older age, anxiety-depressive disorders, chronic stressors, and minor MRI-detected brain lesions.
Aim:
To study the prevalence of cognitive disorders (CD) and clinical/pathogenetic correlations of CD in patients with Behçet's Disease (BD).
Material And Methods:
One hundred and six BD patients were enrolled in the study. The majority of patients were natives of the North Caucasus (51.9%). Mean age was 33.3±0.98 years, mean illness duration 148.5±10.4 months. All the patients met the criteria of the International Study Group for BD (1990) classification. The disease activity was assessed by scoring system BDCAF. A diagnosis of a mental disorder (MD) was established by the psychiatrist in accordance with the ICD-10 using a semi-structured interview. The Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HAM-A), a pathopsychological method 'Pictograms', clinical/psychological methods for assessment of cognitive functions (memory, attention concentration, logic thinking) were administered. Brain MRI was done in 44 (41.5%) BD patients. The study was conducted in the frames of the interdisciplinary program 'Stress factors and mental disorders in immune-mediated inflammatory rheumatic diseases'.
Results:
CD of mild to moderate severity were diagnosed in 82 (77.4%) and anxiety-depressive disorders in 81 (76.4%) of BD patients. The patients with CD were older compared to patients without cognitive disorders (34.3±1.07 vs 29.0±2.14, p=0.006). Patients with CD were most often (84.1% vs 50.0%, p=0.001) diagnosed with anxiety-depressive disorder (anxiety, chronic/recurrent depression). MADRS scores were higher (16.1±0.74 vs 12.2±1.06, p=0.005) though did not exceed the moderate level. The impact of chronic psychosocial stressors was detected more often in CD patients. MRI results showed that the frequency of chronic multifocal, predominantly subcortical, changes in the white matter was higher in CD patients.
Conclusion:
CD are characteristic of most patients with BD. They are associated with the age, anxiety-depressive disorders, chronic stressors and minor brain multifocal subcortical parenchymal MRI lesions.