Ghaleb Rasha M, Said Hussin M
Rheumatology and Rehabilitation Department, Minia University, Egypt.
Neurology and Psychiatry Department, Minia University, Egypt.
Reumatologia. 2024;62(3):169-175. doi: 10.5114/reum.2024.141289. Epub 2024 Jul 12.
There is limited knowledge on cognitive performance in Behçet's disease (BD), the majority of which come from patients with neuro-Behçet's disease. However, the influence of BD on cognitive function in patients without neurological involvement is still not well understood.The aim of the study was to determine the frequency of cognitive involvement in BD patients without evident neuropsychiatric symptoms and to identify associated clinical variables in those patients.
Forty BD patients who fulfilled the diagnostic International Criteria for Behçet 's Disease (ICBD) without obvious neuropsychiatric manifestations were studied and compared with forty healthy controls matched for age, sex, and education. A comprehensive medical history, rheumatological, neurological, psychiatric, and psychometric assessment were applied for all patients. Behçet's disease Current Activity Form (BDCAF) was used to assess disease activity. For patients as well as controls, validated Arabic versions of the Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale-Revised were used for assessment of cognitive function. Anxiety and depression were additionally assessed for both groups using the anxiety and depression subdivisions of the Arabic Version of Symptom Checklist 90 Revised.
Cognitive impairment was identified in 37.5% of BD patients compared to none of the controls. Memory represents the cognitive domain most frequently affected. Cognitive involvement was significantly associated with current corticosteroid use and depression as measured by SCL-90-R. On the other hand, neither the activity of the disease nor the level of anxiety was associated with cognitive involvement.
Cognitive dysfunction is reported in BD patients distinctly and independently of clinically overt neurologic involvement. Prevalence of cognitive impairment in patients with BD is strikingly high at 37.5%, whereas the control group exhibited no such signs. Psychological assessment should be performed for every BD patient to reveal any cognitive involvement. It is highly recommended to encourage psychological intervention to prevent any further deterioration, especially in patients who are experiencing depression or currently using corticosteroids.
白塞病（BD）患者认知功能方面的知识有限，其中大部分来自神经白塞病患者。然而，BD对无神经受累患者认知功能的影响仍未得到充分理解。本研究的目的是确定无明显神经精神症状的BD患者认知受累的频率，并识别这些患者相关的临床变量。
研究了40例符合白塞病国际诊断标准（ICBD）且无明显神经精神表现的BD患者，并与40名年龄、性别和教育程度相匹配的健康对照进行比较。对所有患者进行了全面的病史、风湿病学、神经学、精神病学和心理测量评估。使用白塞病当前活动表（BDCAF）评估疾病活动度。对于患者和对照，使用经过验证的阿拉伯语版韦氏成人智力量表修订版和韦氏记忆量表修订版评估认知功能。此外，使用阿拉伯语版症状自评量表90修订版的焦虑和抑郁子量表对两组进行焦虑和抑郁评估。
37.5%的BD患者存在认知障碍，而对照组无一例出现。记忆是最常受影响的认知领域。认知受累与目前使用皮质类固醇以及SCL - 90 - R测量的抑郁显著相关。另一方面，疾病活动度和焦虑水平均与认知受累无关。
BD患者存在明显的认知功能障碍，且独立于临床明显的神经受累。BD患者认知障碍的患病率高达37.5%，令人震惊，而对照组未出现此类迹象。应对每位BD患者进行心理评估，以发现任何认知受累情况。强烈建议鼓励进行心理干预，以防止病情进一步恶化，尤其是对于正在经历抑郁或目前正在使用皮质类固醇的患者。
