Urbain Fanny, Hardy-Léger Isabelle, Adebs-Nasser Ghaidaa, de Menthon Mathilde, Pivert Cécile, Mausoléo Aude, Laparra Ariane, Lerolle Nathalie, Domnariu Paul-Albert, Lambotte Olivier, Denier Christian, Goujard Cécile, Castro-Gordon Alicia, Noel Nicolas
Internal Medecine and Clinical Immunology Department, AP-HP, Hôpital Bicêtre, Groupe Hospitalier Universitaire Paris Saclay, F-94275 Le Kremlin-Bicêtre, France.
Faculty of Medicine, Paris Saclay University, F-94275 Le Kremlin-Bicêtre, France.
J Clin Med. 2023 Apr 27;12(9):3149. doi: 10.3390/jcm12093149.
Behçet's disease (BD) is a rare form of vasculitis involving both veins and arteries of all calibers. Psychological symptoms and cognitive impairment appear to be frequent, but few data are available.
All consecutive patients in our center fulfilling the 2013 BD criteria underwent a psychometric evaluation with auto- (SCL-90-R and Modified Fatigue Index) and hetero-questionnaires (MINI). A standardized test battery assessed cognitive dysfunction. Data were correlated with BD activity as well as quality of life (SF-36).
We included 20 consecutive patients (16 men, four women) with a median [IQR] age of 38 (30.0-45.5) and a median disease duration of 7 years (1.8-11.0). Five patients had an abnormal brain MRI. The SCL-90-R questionnaire highlighted eight psychopathological profiles (42.1%) that correlated with altered quality of life and more severe fatigue. The most frequent symptoms were anxiety (9/19, 47.4%), somatization (8/19, 42.1%) and phobia (5/19, 26.3%). Psychopathological symptoms appeared to be more severe, but not more frequent, in neuro-Behçet's patients. Based on standardized cognitive evaluation, nine patients had cognitive impairment defined by three or more altered tests. Notably, 6/9 patients did not have any complaint of memory loss and were thus considered ansognostic.
Cognitive involvement was significantly associated with BD activity score (BSAS) but not with brain MRI abnormalities.
白塞病（BD）是一种罕见的血管炎形式，累及各种管径的动静脉。心理症状和认知障碍似乎很常见，但相关数据较少。
我们中心所有符合2013年BD标准的连续患者均接受了心理测评，采用自评问卷（症状自评量表-90修订版[SCL-90-R]和改良疲劳指数）和他评问卷（简明国际神经精神访谈[MINI]）。一套标准化测试评估认知功能障碍。数据与BD活动度以及生活质量（健康调查简表[SF-36]）相关。
我们纳入了20例连续患者（16例男性，4例女性），年龄中位数[四分位间距]为38岁（30.0 - 45.5），疾病持续时间中位数为7年（1.8 - 11.0）。5例患者脑部磁共振成像（MRI）异常。SCL-90-R问卷突出显示了8种精神病理学特征（42.1%），这些特征与生活质量改变和更严重的疲劳相关。最常见的症状是焦虑（9/19，47.4%）、躯体化（8/19，42.1%）和恐惧（5/19，26.3%）。神经白塞病患者的精神病理学症状似乎更严重，但出现频率并不更高。基于标准化认知评估，9例患者存在认知障碍，定义为三项或更多测试结果异常。值得注意的是，6/9的患者没有任何记忆丧失的主诉，因此被认为是病感失认。
认知受累与BD活动评分（BSAS）显著相关，但与脑部MRI异常无关。
