Validation of the Brief Cognitive Symptoms Index in Sjögren Syndrome

Segal, Barbara; Rhodus, Nelson L.; Sivils, Kathy L.; Solid, Craig A.

doi:10.3899/jrheum.140362

Cited by 7 publications

(11 citation statements)

References 46 publications

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“…The main goals of these studies were (1) to explore general neurological complications, [5–7,11] (2) to study the relation between brain imaging and cognitive impairment, [8,12,15–17,43] (3) to assess the impact of clinical features on cognition, [9,18,44] (4) to follow the evolution of cognitive disorders, [45] (5) to describe a study case, [14] (6) to analyze the difference between lupus and pSS, [10] and (7) to adapt a test of cognitive complaint for pSS. [13] Overall, 473 pSS patients were explored and a fronto-sub-cortical alteration with attentional, executive, memory and visuo-spatial disorders was described. However, the prevalence of the cognitive impairment was highly variable in the studies probably due to heterogeneity of patient populations and to analytical factors.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…However, the prevalence of the cognitive impairment was highly variable in the studies probably due to heterogeneity of patient populations and to analytical factors. On the one hand, patient selection was based on pSS criteria including patients with variable extraglandular manifestations associated or not with cognitive disorders and on the other hand, analytical strategies were variable: 11 studies carried out group analyses compared to control groups, [8–10,12,13,15,16,18,43–45] 12 studies compared patient's performances to normative data, [5–12,15–17,43] whereas 6 reports gave a specific cut-off to define a cognitive impairment. [6,9,10,12,15,43] …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Pain is a major clinical symptom of pSS; however, with only 3 studies, the impact of pain on cognition seems underexplored [9,12,13] comparatively to depression (12 studies) [6–10,12,13,16,18,43–45] and fatigue (8 studies). [8–10,12,13,18,44,45] In these 3 studies on pain, Segal et al found discordant results.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…[8–10,12,13,18,44,45] In these 3 studies on pain, Segal et al found discordant results. First, in 2010, the findings did not show any impact of pain on cognitive performance [12] whereas in 2012 and 2014, the new results revealed some involvement of cognitive profiles.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…First, in 2010, the findings did not show any impact of pain on cognitive performance [12] whereas in 2012 and 2014, the new results revealed some involvement of cognitive profiles. In 2014, this author found differences in pain levels according to the intensity of the cognitive complaints [13] and, in 2012, a significant correlation between pain and executive performances particularly with TMT-B and Stroop test in pSS patients was detected. [9] …”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

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Impact of pain on cognitive functions in primary Sjögren syndrome with small fiber neuropathy

et al. 2017

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Primary Sjögren syndrome (pSS) is a chronic systemic autoimmune disease characterized by xerophthalmia, xerostomia, and potential peripheral or central neurological involvement. In pSS, the prevalence of cognitive disorders is generally sparse across literature and the impact of pain on cognitive profile is unclear. The aim of this study was to determine the relation between pain, cognitive complaint, and impairment in a very homogenous population of 10 pSS patients with painful small fiber neuropathy (PSFN) and spontaneous cognitive complaint. Neurological exam, neuropsychological assessment, clinical evaluation measuring pain level, fatigue, anxiety, depression, and cognitive complaint were performed. Our results showed that 100% of patients had cognitive dysfunction especially in executive domain (80%). The most sensitive test was the Wisconsin Card Sorting Test (WCST), abnormal in 70% of our population. Moreover, we found clear cut significant correlations between pain levels and 3 measures of WCST: the number of errors (R = –0.768, P = .0062), perseverations (R = 0.831, P = .0042), and categories (R = 0.705, P = .02). In the literature review, the impact of pain is underexplored and results could be discordant. In a homogeneous cohort of pSS patients with PSFN, a cognitive complaint seems to be a valid reflection of cognitive dysfunction marked by a specific executive profile found with the WCST. In this preliminary study, this profile is linked to the level of pain and highlights that an appropriate management of pain control and a cognitive readaptation in patients could improve the quality of life.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

See 3 more Smart Citations

Impact of pain on cognitive functions in primary Sjögren syndrome with small fiber neuropathy

et al. 2017

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Gulf War illness (GWI) as a neuroimmune disease

et al. 2017

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Gulf War illness (GWI) is a chronic disease characterized by the involvement of several organs, including the brain (Christova et al., Exp Brain Res doi: 10.1007/s00221-017-5010-8 , 2017). In a previous study (Georgopoulos et al., J Neural Eng 4:349-355, 2015), we identified six protective alleles from Class II human leukocyte antigen (HLA) genes, and more recently, we investigated the brain correlates of this protection (James et al., EBioMedicine 13:72-79, 2016). Those and other studies (Israeli, Lupus, 21:190-194, 2012) suggested an involvement of the immune system in GWI. In a recent study (Engdahl et al., EBioMedicine doi: 10.1016/j.ebiom.2016.08.030 , 2016), we showed that the brain pattern of synchronous neural interactions (SNI; Georgopoulos et al., J Neural Eng 4:349-355, 2007) in GWI is distinctly different from that in healthy controls. Here we focused on the SNI itself, as a basic measure of neural communication (irrespective of specific connections) and compared it between GWI and seven other diseases that cover a broad spectrum of etiology and pathophysiology. Specifically, we sought to determine which, if any, of those diseases might resemble GWI SNI, overall and within the HLA protective domain, and thus gain further knowledge regarding the nature of GWI brain abnormality. We studied a total of 962 participants from a healthy control population (N = 583) and eight different diseases, including GWI (N = 40), schizophrenia (SZ; N = 21), Alzheimer's disease (AD; N = 66), posttraumatic stress disorder (PTSD; N = 159), major depressive disorder (MDD; N = 10), relapsing-remitting multiple sclerosis (RRMS; N = 43), Sjögren's syndrome (SS; N = 32), and rheumatoid arthritis (RA; N = 8). They all underwent a resting-state magnetoencephalographic (MEG) scan to calculate SNIs. Data were analyzed using analysis of covariance (ANCOVA) with disease as fixed factor, and sex and age as covariates. We found that GWI SNIs differed significantly from control SZ, AD, PTSD and MDD but not from RRMS, SS and RA. In addition, we compared GWI to RRMS, SS and RA with respect to SNIs of MEG sensor pairs that were related to the HLA alleles protective for GWI (James et al., EBioMedicine 13:72-79, 2016). We found that GWI SNIs did not differ significantly from any of these three diseases but they did so from control SZ, AD, PTSD and MDD. These findings indicate that (a) GWI brain synchronicity does not differ significantly from that of known immune-related diseases (RRMS, SS, RA), and (b) that this SNI similarity is present within the HLA-related SNIs. In contrast, GWI SNIs differed significantly from those of the other diseases. We conclude that altered brain communication in GWI likely reflects immune-related processes, as postulated previously (James et al., EBioMedicine 13:72-79, 2016). By extension, these findings also indicate that functional brain abnormalities in RRMS, SS and RA might be, in part, due to lack of protective HLA alleles as documented for GWI (Georgopoulos et al., EBioMedicine 3:79-85, 2015).

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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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Validation of the Brief Cognitive Symptoms Index in Sjögren Syndrome

Abstract: The BCSI should be a useful tool for the study of cognitive symptoms in SS. Both self-report and standardized tests should be considered in screening for cognitive disorders in SS.

Cited by 7 publications

References 46 publications

Impact of pain on cognitive functions in primary Sjögren syndrome with small fiber neuropathy

Impact of pain on cognitive functions in primary Sjögren syndrome with small fiber neuropathy

Gulf War illness (GWI) as a neuroimmune disease

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

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