Neuropsychiatric Dysfunction in Primary Sjögren's Syndrome

Malinow, Kenneth L.; Molina, Rodolfo; Gordon, Barak; Selnes, Ola A.; Provost, Thomas T.; Alexander, Elaine L.

doi:10.7326/0003-4819-103-3-344

Cited by 155 publications

(76 citation statements)

References 21 publications

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“…Cognitive impairments in patients with PSS were reported by Malinow 5 and later confirmed by other studies 6,7 . In Brazil, we have not found any case-series studies that have investigated cognitive impairments in PSS.…”

supporting

confidence: 69%

“…No consensus has been reached about the most common CNS manifestations of this disease. According to Malinow et al 5 , the most common manifestations are nonfocal inclu ding cognitive impairments. As suggested by Tobon et al 16 , nonfocal (diffuse) manifestations can be subdiagnosed according to the lack of a specific diagnosis modality.…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric alterations have also been reported to be associated with cognitive impairments related to diffuse encephalic manifestations 5,10 .…”

mentioning

confidence: 99%

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A short neuropsychological evaluation of patients with primary Sjögren's syndrome

Rodrigues

Hora

Salgado

et al. 2014

Arq. Neuro-Psiquiatr.

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Objective: To investigate cognitive deficits in patients with primary Sjögren's syndrome (PSS). Method: Eighteen patients with PSS, aged between 25 and 61 years, were subjected to a short neuropsychological battery and compared with 18 patients with multiple sclerosis and 18 healthy controls. Results: The analysis of variance (ANOVA) revealed that the clinical groups had significantly worse performance than the control group on the Rey Auditory Verbal Learning Test 3; (F 2,53 =3.500, p=0.038) and 7 (F 2,53 =5.068, p=0.010). The clinical groups had elevated levels of depression on the Beck Depression Inventory (BDI); (p=0.003). The analysis of the data from the Trail Making Test B-A revealed a significant difference between the clinical and control groups (p=0.023). The analysis of covariance with BDI score as a covariate, did not change the outcome. Conclusion: Our study revealed cognitive deficits in patients with PSS detectable by a short neuropsychological battery.Keywords: neuropsychological evaluation; Sjögren's syndrome, cognitive impairment, neuropsychology. Primary Sjögren's syndrome (PSS) is an inflammatory autoimmune disease characterized by infiltration of exocrine glands. It occurs without an association with other connective tissue diseases and affects mainly salivary and lachrymal glands, causing xerostomy and keratoconjunctivitis sicca 1,2 . It often afflicts middle-age women, with an estimated prevalence of 2% in the adult population 3 . Moreover, PSS can be associated with impairments of the nervous system. In the central nervous system (CNS), the focal and nonfocal involvement of the brain and spinal cord has been described, resulting in a wide spectrum of neurological, psychiatric, and cognitive symptoms 4 .Cognitive impairments in patients with PSS were reported by Malinow 5 and later confirmed by other studies 6,7 . In Brazil, we have not found any case-series studies that have investigated cognitive impairments in PSS. We found one case report 8 .The results from other countries suggest that patients with PSS display cognitive impairments in attention, memory,

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supporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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A short neuropsychological evaluation of patients with primary Sjögren's syndrome

Rodrigues

Hora

Salgado

et al. 2014

Arq. Neuro-Psiquiatr.

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“…Central nervous system (CNS) complications of primary SS (CNS-SS) are becoming recognized increasingly. A spectrum of CNS manifestations has been observed, including focal neurologic deficits, psychiatric disturbances, cognitive dysfunction, seizure of movement disorders, recurrent aseptic meningoencephalitis (AME), and acute and chronic myelopathy (5)(6)(7)(8)(9).…”

Section: Evidence Of An Immunopathogenic Basis For Central Nervous Symentioning

confidence: 99%

Evidence of an immunopathogenic basis for central nervous system disease in primary Sjögren's syndrome

Alexander

Lijewski

Jerdan

et al. 1986

Arthritis & Rheumatism

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The pathogenesis of central nervous system complications in primary Sjögren's syndrome (CNS‐SS) is unknown. In order to determine whether patients with active CNS‐SS have cerebrospinal fluid (CSF) abnormalities indicative of CNS inflammation, CSF analyses from 30 patients with active CNS‐SS (SSA) were contrasted with those from 20 SS patients without CNS involvement (SSI) and 20 patients with systemic lupus erythematosus and active CNS disease (SLEA). Elevations of total protein concentration, IgG concentration, IgG to total protein ratio, and IgG index were observed in patients with SSA, but not in those with SSI. Agarose gel electrophoresis results were abnormal, with 1 or more bands, in 25 of 29 SSA patients (86%), but in only 3 of 18 SSI patients (17%). Similar, but less striking, CSF abnormalities were seen in a minority of SLEA patients. Fifteen SSA patients (50%) had transient, mild‐to‐moderate CSF pleocytosis, while only 1 SSI patient and 2 SLEA patients had similar findings. Cytologic findings were abnormal in 18 SSA patients (60%); these included atypical mononuclear cells, lymphoblastoid cells, and plasma cells. The presence of immuno‐competent cells and evidence for the intrathecal synthesis of IgG within the CSF of SSA, but not SSI, patients provide diagnostic parameters which are indicative of active disease and which can be monitored serially during therapy.

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“…Так, по некоторым данным, сред-няя длительность периода от развития пер-вых симптомов БШ до ее диагностики и на-чала адекватного лечения составляет около 7 лет [18]. В связи с этим психические рас-стройства и провоцирующие стрессовые фа-кторы при БШ требуют особого внимания [19][20][21][22].…”

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Stress Factors and Mental Disorders in Sjogren's Disease: Modern Trends in Research

Shelomkova¹,

Veltishchev²,

Васильев³

et al. 2012

rsp

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Neuropsychiatric Dysfunction in Primary Sjögren's Syndrome

Cited by 155 publications

References 21 publications

A short neuropsychological evaluation of patients with primary Sjögren's syndrome

A short neuropsychological evaluation of patients with primary Sjögren's syndrome

Evidence of an immunopathogenic basis for central nervous system disease in primary Sjögren's syndrome

Stress Factors and Mental Disorders in Sjogren's Disease: Modern Trends in Research

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