Systemic sclerosis and its cerebral, neurological, and psychiatric impacts: a narrative review

Neurological manifestations of Systemic Sclerosis (SSc) encompass psychiatric disorders, peripheral neuropathy (PN), and cerebrovascular complications, significantly impacting patient quality of life. Psychological assessments reveal high levels of distress linked to depression, anxiety, fatigue, and cognitive impairment. Although PN is less frequent, its distinct profile in SSc suggests intrinsic disease mechanisms, sometimes presenting as an early symptom. Key features of SSc, including microvascular dysfunction, fibroproliferative processes, and vasculitis, elevate stroke risk through atherosclerosis and vascular calcification. Additionally, oxidative stress plays a central role in neural damage, with Reactive Oxygen Species (ROS) contributing to neurological symptoms. This review highlights the diverse neurological outcomes of SSc, underscoring the need for integrative management strategies that address overlooked comorbidities and optimize patient care.