Cognitive dysfunction in Sjögren’s syndrome using the Montreal Cognitive Assessment Questionnaire and the Automated Neuropsychological Assessment Metrics: A cross‐sectional study

Riega-Torres, Janett; Treviño-Castro, M. A.; Hernandez-Galarza, I. D. J.; Martinez, Mayra Judith Garza; Vera-Pineda, Raymundo; Garza, Jesús Alberto Cárdenas‐de la; Garza, Patricia Rodriguez-de la; Skinner-Taylor, Cassandra Michele; Galarza‐Delgado, Dionicio Ángel

doi:10.1111/1756-185x.13889

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…In accordance with literature data 36 , pSS patients presented mainly memory complaints and more than half of them exhibited pathological scores for global memory, executive functions, or instrumental functions. The proportions of patients with impaired executive functions and visuospatial skills are consistent with previous studies 4 , 9 , 10 , 36 . However, our approach, including a wide range of tests and a personalized comprehensive evaluation of each patient, was more sensitive than previous studies, and allowed an early detection of cognitive impairments (borderline scores), and their interpretation with other cofounding factors.…”

Section: Discussionsupporting

confidence: 91%

“…Most patients report “brain fog” symptoms 2 , described as memory lapses, forgetfulness, mental confusion, diminished ability to concentrate, to organize, or to anticipate future events. The precise neuropsychological pattern of pSS is not fully deciphered, however, executive functions are often abnormal 9 , 10 . The interplay between cognitive complaints, cognitive impairment, fatigue, depression 11 , sleep disorders 12 , and pain is not fully understood in pSS.…”

Section: Introductionmentioning

confidence: 99%

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The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

Goulabchand

Castille

Navucet

et al. 2022

Sci Rep

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Primary Sjögren’s syndrome (pSS) is an autoimmune disease with frequent neurological involvement. Memory complaints are common, but their precise patterns remain unclear. We wanted to characterize patterns of neurocognitive profiles in pSS patients with cognitive complaints. Only pSS patients with memory complaints were included, prospectively. Cognitive profiles were compiled through a comprehensive cognitive evaluation by neuropsychologists. Evaluations of anxiety, depression, fatigue, sleep disorders and quality of life were performed for testing their interactions with cognitive profiles. All 32 pSS patients showed at least borderline cognitive impairment, and 17 (53%) exhibited a pathological cognitive profile: a hippocampal profile (37%), a dysexecutive profile (22%), and an instrumental profile (16%) (possible overlap). Regarding the secondary objectives: 37% of patients were depressed, and 48% exhibited a mild-to-severe anxiety trait. Sleep disorders were frequent (excessive daytime sleepiness (55%), high risk for sleep apnea (45%), and insomnia (77%)). Cognitive impairments could not be explained alone by anxiety, depression or sleep disorders. Fatigue level was strongly associated with sleep disorders. Our study highlights that cognitive complaints in pSS patients are supported by measurable cognitive impairments, apart from frequently associated disorders such as depression, anxiety or sleep troubles. Sleep disorders should be screened.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

Goulabchand

Castille

Navucet

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…This may require an early multidisciplinary approach integrating neurologists and internists which focuses on these complaints and their course. An early screening of cognitive complaints through validated tools (such as the Brief Cognitive Symptoms Inventory (BCSI) or the Montreal cognitive assessment (MoCa)) could be used in daily practice [ 28 , 29 ]. In case of abnormalities, a complete neuropsychological work-up could help establish the impaired cognitive functions’ subdomains and how to treat them.…”

Section: Discussionmentioning

confidence: 99%

Hospitalization Risks for Neurological Disorders in Primary Sjögren’s Syndrome Patients

Goulabchand

Gabelle

Ayrignac

et al. 2022

JCM

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Primary Sjögren’s syndrome (pSS) can be associated with neurological and cognitive involvement, negatively affecting patients’ quality of life. The aim of this study was to assess whether pSS patients are at higher risk of hospitalization for neurological diseases. Through a nationwide retrospective study using the French Health insurance database (based on International Classification for Disease codes, ICD-10), we selected patients hospitalized with new-onset pSS between 2011 and 2018. We compared the incidence of hospitalization for dementia, multiple sclerosis (MS), encephalitis, and peripheral neuropathy with an age- and sex-matched (1:10) hospitalized control group. Adjusted Hazard Ratios (aHR) considered confounding factors, particularly socio-economic status and cardiovascular diseases. We analyzed 25,661 patients hospitalized for pSS, compared with 252,543 matched patients. The incidence of hospitalization for dementia was significantly higher in pSS patients (aHR = 1.27 (1.04–1.55); p = 0.018), as well as the incidence of hospitalization for MS, encephalitis, and inflammatory polyneuropathies (aHR = 3.66 (2.35–5.68), p < 0.001; aHR = 2.66 (1.22–5.80), p = 0.014; and aHR = 23.2 (12.2–44.5), p < 0.001, respectively). According to ICD-10 codes, pSS patients exhibited a higher incidence of hospitalization for dementia, encephalitis, MS, and peripheral neuropathies than controls. Physicians must be aware of these neurological risks to choose the most appropriate diagnostic work-up.

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“…Diagnostic tests to detect sicca symptoms were not performed routinely, as every patient with pSS did not receive an MRI scan or an electrophysiological workup. Morreale et al proposed an association of pSS with headache syndromes and neurocognitive/psychological disorders ( 38 ), and a recent study has focused on cognitive dysfunction and dementia in pSS ( 39 , 40 ), which we did not address either. Moreover, we were not able to recapitulate each individual treatment decision hindering a more systematic analysis.…”

Section: Discussionmentioning

confidence: 84%

CNS demyelinating events in primary Sjögren's syndrome: A single-center case series on the clinical phenotype

et al. 2023

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ObjectiveThe study aimed to assess the prevalence, clinical characteristics, and therapeutic outcomes of the central nervous system (CNS) demyelinating disease in a large cohort of primary Sjögren's syndrome (pSS).MethodsThis is an explorative cross-sectional study of patients with pSS seen in the departments of rheumatology, otorhinolaryngology, or neurology of a tertiary university center between January 2015 and September 2021.ResultsIn a cohort of 194 pSS patients, 22 patients had a CNS manifestation. In this CNS group, 19 patients had a lesion pattern suggestive of demyelination. While there were no obvious differences in the patients' epidemiological disposition or rate of other extraglandular manifestations, the CNS group differed from the remaining patients with pSS by having less glandular manifestations but a higher seroprevalence for anti-SSA/Ro antibodies. Notably, patients with CNS manifestations were often diagnosed with multiple sclerosis (MS) and treated as such, although age and disease course were atypical of MS. Many first-line MS agents were ineffective in these “MS look-alikes”; however, the disease course was benign with B-cell-depleting agents.ConclusionNeurological symptoms of pSS are common and clinically manifest mainly as myelitis or optic neuritis. Notably, in the CNS, the pSS phenotype can overlap with MS. The prevailing disease is crucial since it has a major impact on the long-term clinical outcome and the choice of disease-modifying agents. Although our observations neither confirm pSS as a more appropriate diagnosis nor rule out simple comorbidity, physicians should consider pSS in the extended diagnostic workup of CNS autoimmune diseases.

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Cognitive dysfunction in Sjögren’s syndrome using the Montreal Cognitive Assessment Questionnaire and the Automated Neuropsychological Assessment Metrics: A cross‐sectional study

Cited by 8 publications

References 18 publications

The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients

Hospitalization Risks for Neurological Disorders in Primary Sjögren’s Syndrome Patients

CNS demyelinating events in primary Sjögren's syndrome: A single-center case series on the clinical phenotype

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