Topçuoğlu Özgür Bilgin, Kavas M, Alibaş Hande, Afşar Gülgün Çetintaş, Arınç Sibel, Midi İpek, Elmacı Neşe Tuncer
Department of Neurology, Süreyyapaşa Chest Diseases and Thorax Surgery Training and Research Hospital, Maltepe, Istanbul, Turkey.
Department of Neurology, Marmara University School of Medicine,Üstkaynarca, Pendik, Istanbul, Turkey.
Sarcoidosis Vasc Diffuse Lung Dis. 2018;35(1):26-34. doi: 10.36141/svdld.v35i1.5940. Epub 2018 Apr 28.
Sarcoidosis is a multisystem, inflammatory disease characterized by non-caseating granulomas in multiple organs. Neuropsychological impairment has been told to be present in about 10% of sarcoidosis patients with diagnosed central nervous system (CNS) involvement. Both anatomical lesions and changes in immunological parameters in sarcoidosis may cause cognitive impairment. Based on the information that soluble interleukin-2 receptors (sIL-2R) and tumour necrosis factor alpha (TNF-‱) which plays a role in the pathogenesis of sarcoidosis accumulate in the basal ganglia and prefrontal structures, impairment in executive functioning is most likely to be expected in sarcoidosis. In this study we aimed to evaluate executive functions in sarcoidosis patients. This study included 21 sarcoidosis patients (14 females, 7 males) and 21 healthy controls (12 females, 9 males). All participants were given Beck Depression Inventory-Second Edition, Stroop Test, Verbal Fluency Tests, Digitspan Forward Test, Digitspan Backwards Test and Trail Making Test Part-B. Test results of sarcoidosis patients were compared with healthy controls. No significant difference was detected between sarcoidosis patients and healthy controls by means of neuropsychological assessment tests (p>0.05). Our study showed that sarcoidosis patients did not have impairment in executive functions. This result may be commented in two different outcomes. One of them, would be the probable necessity of additional electrophysiological or radiological tests including detailed paradigmas for evaluation of executive functions. Secondly the effect of therapeutics used in sarcoidosis (steroids and/or immunosuppressants) on cognition should be questioned regarding the controversial previous data which released cognitive decline in sarcoidosis. .
结节病是一种多系统炎症性疾病,其特征是多个器官出现非干酪样肉芽肿。据报道,在已确诊中枢神经系统(CNS)受累的结节病患者中,约10%存在神经心理损害。结节病中的解剖学病变和免疫参数变化均可能导致认知障碍。基于可溶性白细胞介素-2受体(sIL-2R)和在结节病发病机制中起作用的肿瘤坏死因子α(TNF-α)在基底神经节和前额叶结构中积聚的信息,结节病患者最有可能出现执行功能障碍。在本研究中,我们旨在评估结节病患者的执行功能。本研究纳入了21例结节病患者(14例女性,7例男性)和21名健康对照者(12例女性,9例男性)。所有参与者均接受了贝克抑郁量表第二版、斯特鲁普测验、语言流畅性测验、数字广度顺背测验、数字广度倒背测验和连线测验B部分。将结节病患者的测试结果与健康对照者进行比较。通过神经心理评估测试,未发现结节病患者与健康对照者之间存在显著差异(p>0.05)。我们的研究表明,结节病患者没有执行功能障碍。这一结果可能有两种不同的解读。其一,可能需要进行额外的电生理或放射学检查,包括评估执行功能的详细范式。其二,鉴于先前有争议的数据表明结节病存在认知功能下降,应质疑结节病治疗中使用的药物(类固醇和/或免疫抑制剂)对认知的影响。