Xu Dong, He Yang, Xu Dan, Chen Beidi, Li Xue, Zhang Xiaoying, Zhang Jun, Shen Ming, Mu Rong
Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing.
Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region.
Rheumatology (Oxford). 2022 May 30;61(6):2457-2463. doi: 10.1093/rheumatology/keab787.
Nervous system damage in patients with SSc has recently attracted attention. In this study, we aimed to explore mild cognitive impairment (MCI) in SSc patients and the characteristics of these patients.
A total of 103 SSc patients were consecutively enrolled from July 2018 to May 2019, and 97 matched healthy individuals were also included as controls. Brief cognitive tests, such as the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), were used to assess the cognitive function of all subjects. We compared the differences in MCI between SSc patients and healthy controls, as well as the differences in demographic and clinical features between SSc patients with and without MCI. Associations of quantitative demographic and clinical features with MoCA-BJ scores in the SSc patients were also evaluated.
The score of MoCA-BJ was lower in the SSc group compared with those in the healthy group [24 (9-30) vs 26 (15-30), P < 0.001]. MCI (MoCA-BJ score ≤ 25) was found in 61.2% (63/103) of the enrolled SSc patients but only in 27.8% (27/97) of the healthy individuals. Other tests evaluating some of the specific domains of cognitive functions showed that the SSc patients had impaired memory, attention and executive ability. Compared with SSc patients without MCI, SSc patients with MCI had lower education level, total serum protein and serum albumin but higher ANA positivity.
MCI is common in patients with SSc and should be drawn to the attention of rheumatologists. Lower education level, malnutrition and higher ANA positivity were closely related to the cognitive dysfunctions in SSc patients, providing directions for further interventions.
系统性硬化症（SSc）患者的神经系统损伤最近受到关注。在本研究中，我们旨在探讨SSc患者的轻度认知障碍（MCI）及其特征。
2018年7月至2019年5月连续纳入103例SSc患者，并纳入97例匹配的健康个体作为对照。使用简短认知测试，如北京版蒙特利尔认知评估量表（MoCA-BJ），评估所有受试者的认知功能。我们比较了SSc患者与健康对照之间MCI的差异，以及有和无MCI的SSc患者在人口统计学和临床特征方面的差异。还评估了SSc患者定量人口统计学和临床特征与MoCA-BJ评分之间的关联。
SSc组的MoCA-BJ评分低于健康组[24（9-30）对26（15-30），P＜0.001]。在纳入的SSc患者中，61.2%（63/103）存在MCI（MoCA-BJ评分≤25），而健康个体中仅为27.8%（27/97）。评估认知功能某些特定领域的其他测试表明，SSc患者存在记忆、注意力和执行能力受损。与无MCI的SSc患者相比，有MCI的SSc患者教育水平较低、总血清蛋白和血清白蛋白较低，但抗核抗体（ANA）阳性率较高。
MCI在SSc患者中很常见，应引起风湿病学家的注意。较低的教育水平、营养不良和较高的ANA阳性率与SSc患者的认知功能障碍密切相关，为进一步干预提供了方向。
