Department of Dermatology and Venerology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Department of Radiology and Diagnostic Imaging, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Int J Environ Res Public Health. 2022 May 7;19(9):5687. doi: 10.3390/ijerph19095687.
Psoriasis is a severe inflammatory disease associated with a higher comorbidity of depression, cognitive dysfunction and brain atrophy. The association between psoriasis, magnetic resonance imaging (MRI) markers and cognitive impairment has rarely been investigated, and the existing results are conflicting.
This study included 89 subjects (53 patients with psoriasis and 36 healthy controls). The severity of psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI) score; for depression, the Hospital Anxiety and Depression Scale (HADS) scale was used. Neuropsychological tests were also applied, including a Trail Making Test (TMT) as well as Digit Span, Stroop, Verbal Fluency and Rey Auditory Verbal Learning tests. MRI scans were performed using a 1.5 T scanner. Brain volumetry, white matter lesions, grey matter and white matter were evaluated. The extent of these changes was assessed on the Fazekas scale. The differences between groups were evaluated using a Student's -test and a Mann-Whitney U test, and a Pearson correlation analysis was also performed.
Patients with psoriasis presented worse achievements on all the neuropsychological tests and showed more intense changes on MRI compared to healthy controls. The severity of psoriasis as determined by PASI scores was associated with depression, and a greater psychomotor slowness severity of changes in the brain was associated with poorer results on the neurological tests.
Our results indicate the possibility of progressive brain atrophy related to cognitive decline in psoriasis.
银屑病是一种严重的炎症性疾病，与抑郁、认知功能障碍和脑萎缩的合并症发生率较高相关。银屑病、磁共振成像（MRI）标志物与认知障碍之间的关联很少被研究，现有的结果也存在矛盾。
本研究纳入 89 名受试者（53 名银屑病患者和 36 名健康对照者）。银屑病严重程度采用银屑病面积和严重程度指数（PASI）评分评估；抑郁采用医院焦虑和抑郁量表（HADS）评估。还进行了神经心理学测试，包括连线测试（TMT）以及数字跨度、斯特鲁普、言语流畅性和 Rey 听觉言语学习测试。MRI 扫描使用 1.5 T 扫描仪进行。评估脑容积、白质病变、灰质和白质。使用 Fazekas 量表评估这些变化的程度。使用 Student's -检验和 Mann-Whitney U 检验评估组间差异，并进行 Pearson 相关分析。
银屑病患者在所有神经心理学测试中的表现均较差，且与健康对照组相比，MRI 显示出更明显的变化。PASI 评分确定的银屑病严重程度与抑郁有关，且大脑变化的精神运动缓慢严重程度与神经学测试的较差结果相关。
我们的结果表明，银屑病可能与认知能力下降相关的进行性脑萎缩有关。
