Allied Health - Psychology, Melbourne Health, Royal Melbourne Hospital, 300 Grattan St, Parkville, Melbourne, Victoria, 3052, Australia.
Neuropsychology Service, The Melbourne Clinic, Healthscope, Richmond, Melbourne, Australia.
Neuropsychol Rev. 2019 Dec;29(4):498-521. doi: 10.1007/s11065-019-09416-5. Epub 2019 Sep 7.
Behçet's disease (BD) is a vascular, inflammatory multisystem disorder with neuro-Behçet's (NBD) diagnosed in a subset of patients with neurological manifestations. The objective of this review was to determine whether neurocognitive dysfunction is observed in BD, in which neurocognitive domains, and whether there are differences in rates of dysfunction observed between BD and NBD groups. Studies of any methodology were included that reported results from standardized neurocognitive assessment measures in participants with BD or NBD. Twelve group comparison studies met the criteria for inclusion in the review (totalling 284 BD and 157 NBD participants), as well as 17 case study/series papers (11 BD, 35 NBD). Issues with blinding, incomplete data reporting and selective reporting bias were found across the group and case study/series papers, as well as inadequate statistical adjustment for multiple comparisons in the group studies, and the lack of the use of appropriate norms or adjustment for premorbid ability in the case series/studies papers. These quality issues impacted on the conclusions that could be drawn from the current literature. Neurocognitive dysfunction was found in NBD compared to health controls (HC) in a higher proportion of results across studies, than in comparisons between BD and HC groups. The domains in which neurocognitive attenuation was most often reported were visual spatial ability, working memory and acquired knowledge, with more than 25% of these results showing significantly lower functioning in both the BD and NBD groups compared to HC. More than 25% of the processing speed and long-term memory encoding and retrieval results were also lower for the NBD group, compared to HC. Group comparisons between NBD and multiple sclerosis participants indicated few significant differences in neurocognitive test results. The majority of case study/series participants were found to have some degree of attenuated neurocognitive functioning, as defined by case study/series authors.
贝赫切特病（BD）是一种血管炎性多系统疾病，其中神经贝赫切特病（NBD）在具有神经表现的患者亚组中诊断。本综述的目的是确定 BD 是否存在神经认知功能障碍，在哪些神经认知领域存在障碍，以及 BD 和 NBD 组之间观察到的功能障碍发生率是否存在差异。纳入了报告了 BD 或 NBD 参与者使用标准化神经认知评估测量结果的任何方法学的研究。共有 12 项组间比较研究符合纳入标准（共有 284 名 BD 和 157 名 NBD 参与者），以及 17 项病例研究/系列论文（11 名 BD，35 名 NBD）。在组和病例研究/系列论文中，发现了存在无法盲法、数据报告不完整和选择性报告偏倚的问题，以及组研究中对多次比较进行充分的统计调整，以及病例系列/研究论文中缺乏使用适当的正常或对发病前能力进行调整的问题。这些质量问题影响了从当前文献中得出的结论。与健康对照组（HC）相比，NBD 组的神经认知功能障碍在研究结果中占比更高，而与 BD 和 HC 组之间的比较结果相比，NBD 组的神经认知功能障碍发生率更高。报道中最常出现的神经认知减弱的领域是视觉空间能力、工作记忆和获得的知识，BD 和 NBD 组与 HC 组相比，这些结果中有超过 25%的结果显示功能明显下降。NBD 组的处理速度和长期记忆编码和检索结果也有超过 25%的结果较低。NBD 组与多发性硬化症参与者之间的组间比较显示神经认知测试结果存在少数显著差异。大多数病例研究/系列参与者被认为存在一定程度的神经认知功能减弱，这是由病例研究/系列作者定义的。
