Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T03:23:02.098Z Has data issue: false hasContentIssue false

No Difference in Cognitive Dysfunction Among Patients with ANCA-Associated Vasculitis, Rheumatoid Arthritis or Chronic Kidney Disease

Published online by Cambridge University Press:  29 April 2019

Natasha Alcocer-Castillejos
Affiliation:
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Ariadna Jiménez-González
Affiliation:
Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Andrea Hinojosa-Azaola*
Affiliation:
Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
*
Correspondence and reprint requests to: Andrea Hinojosa-Azaola, Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Sección XVI, Tlalpan, Mexico City, CP 14000, Mexico. E-mail: [email protected]

Abstract

Objective: To characterize cognitive function in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in comparison with other chronic conditions, and to investigate its association with disease activity, and other psychological factors. Methods: Cross-sectional study including patients with AAV, rheumatoid arthritis (RA) (n = 30), and chronic kidney disease (CKD) (n = 29). Patients underwent a standardized neuropsychological battery (NEUROPSI). Sleep quality, fatigue, depression, and anxiety levels were assessed. Results: A total of 60 patients with AAV were included, median age of 54 years, and disease duration of 5.6 years. Prevalence of cognitive dysfunction (CD) in AAV patients was similar to RA and CKD (35%, 40%, and 39.3%, respectively, p = .88). When AAV patients with (n = 21) and without (n = 39) CD were compared, significantly more patients with CD had high disease activity (67% vs. 31%, p = .009). Abnormal performance was more frequent in the executive functions in the three groups (45% AAV, 51.7% RA, and 50% CKD), followed by language (25%, 13.8%, and 25%, respectively). Verbal and visual attentional tests were more frequently impaired in patients from the CKD group (p = .021), and psychomotor functions were more frequently affected in AAV patients (p < .05). Hospital Anxiety and Depression Scale (HADS) total score (especially anxiety) was higher in patients with memory impairment than in those with normal memory function (M = 6.79, SD = 4.53 vs. M = 4.5, SD = 3.6, p < .01). Neither Sleep Quality Index nor fatigue scale scores differed between those cognitively impaired and not impaired. Conclusions: No statistically significant differences were found in the frequency of CD among the three clinical populations. (JINS, 2019, 25, 595–602)

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adhikari, A., Piatti, A., & Luggen, M. (2011). Cognitive dysfunction in SLE: development of a screening tool. Lupus, 20, 11421146.CrossRefGoogle ScholarPubMed
Aletaha, D., Neogi, T., Silman, A.J., Funovits, J., Felson, D.T., Bingham, C.O. 3rd, Birnbaum, N.S., Burmester, G.R., Bykerk, V.P., Cohen, M.D., Combe, B., Costenbader, K.H., Dougados, M., Emery, P., Ferraccioli, G., Hazes, J.M., Hobbs, K., Huizinga, T.W., Kavanaugh, A., Kay, J., Kvien, T.K., Laing, T., Mease, P., Ménard, H.A., Moreland, L.W., Naden, R.L., Pincus, T., Smolen, J.S., Stanislawska-Biernat, E., Symmons, D., Tak, P.P., Upchurch, K.S., Vencovský, J., Wolfe, F., & Hawker, G. (2010). 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis & Rheumatology, 62, 25692581.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A.A., Haug, T.T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 6977.CrossRefGoogle Scholar
Boada-Grau, J., Merino-Tejedor, E., Gil-Ripoll, C., Segarra-Pérez, G., & Vigil-Colet, A. (2014). Adaptación al español del Inventario Multidimensional de Fatiga al entorno laboral. Universitas Psychologica, 13, 1523.CrossRefGoogle Scholar
Buysse, D.J., Reynolds, C.F. 3rd, Monk, T.H., Berman, S.R., & Kupfer, D.J., (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193213.CrossRefGoogle ScholarPubMed
Capra, R., Gregorini, G., Mattioli, F., Santostefano, M., & Galluzzi, S. (1998). Rapid onset dementia in patients with microscopic polyangiitis. [asbtract]. Journal of Neurology, 245, 397.Google Scholar
Colgecen, E., Celikbilek, A., & Keskin, D.T. (2016). Cognitive impairment in patients with psoriasis: a cross-sectional study using the Montreal Cognitive Assessment. American Journal of Clinical Dermatology, 17, 413419.CrossRefGoogle ScholarPubMed
Covey, T.J., Shucard, J.L., Shucard, D.W., Stegen, S. & Benedict, R.H. (2012). Comparison of neuropsychological impairment and vocational outcomes in systemic lupus erythematosus and multiple sclerosis patients. Journal of the International Neuropsychological Society, 18(3), 530540.CrossRefGoogle ScholarPubMed
Duarte-García, A., Romero-Díaz, J., Juárez, S., Cicero-Casarrubias, A., Fragoso-Loyo, H., Núñez-Alvarez, C., Llorente, L., Sánchez-Guerrero, J. (2018). Disease activity, autoantibodies, and inflammatory molecules in serum and cerebrospinal fluid of patients with systemic lupus erythematosus and cognitive dysfunction. PLoS One, 13. doi: 10.1371/journal.pone.0196487.CrossRefGoogle ScholarPubMed
Exley, A.R., Bacon, P.A., Luqmani, R.A., Kitas, G.D., Gordon, C., Savage, C.O.S., & Adu, D. (1997). Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides. Arthritis & Rheumatology, 40, 371380.CrossRefGoogle ScholarPubMed
Godefroy, O., Azouvi, P., Robert, P., Roussel, M., LeGall, D., Meulemans, T., & Behalf of the Groupe de Réflexion sur l’Evaluation des Fonctions Exécutives Study Group. (2010). Dysexecutive syndrome: diagnostic criteria and validation study. Annals of Neurology, 68, 855864.CrossRefGoogle ScholarPubMed
Hanly, J.G. (2014). Diagnosis and management of neuropsychiatric SLE. Nature Reviews Rheumatology, 10(6), 338347.CrossRefGoogle ScholarPubMed
Hinojosa-Azaola, A., Jiménez-González, A., & Alcocer-Castillejos, N. (2018). Patient and physician perspectives on the impact of health-related quality of life in Mexican patients with ANCA-associated vasculitis. Rheumatology International, 38, 631640.CrossRefGoogle ScholarPubMed
Jarrot, P.A. & Kaplanski, G. (2016). Pathogenesis of ANCA-associated vasculitis: an update. Autoimmunity Reviews, 15, 704713.CrossRefGoogle ScholarPubMed
Jennette, J.C., Falk, R.J., Bacon, P.A., Basu, N., Cid, M.C., Ferrario, F., Flores-Suarez, L.F., Gross, W.L., Guillevin, L., Hagen, E.C., Hoffman, G.S., Jayne, D.R., Kallenberg, C.G., Lamprecht, P., Langford, C.A., Luqmani, R.A., Mahr, A.D., Matteson, E.L., Merkel, P.A., Ozen, S., Pusey, C.D., Rasmussen, N., Rees, A.J., Scott, D.G., Specks, U., Stone, J.H., Takahashi, K., & Watts, R.A. (2013). 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis & Rheumatology, 65, 111.CrossRefGoogle Scholar
Leavitt, R.Y., Fauci, A.S., Bloch, D.A., Michel, B.A., Hunder, G.G., Arend, W.P., Calabresse, L.H., Fries, J.F., Lie, J.T., Lightfoot, R.W., Masi, A.T., McShane, D.J., Mills, J.A., Stevens, M.B., Wallace, S.L., & Zvaifler, N.J. (1990). The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis & Rheumatology, 33, 11011107.CrossRefGoogle ScholarPubMed
Levin,, A. & Stevens, P.E. (2014). Summary of KDIGO 2012 CKD guideline: behind the scenes, need for guidance, and a framework for moving forward. Kidney International, 85, 4961.CrossRefGoogle Scholar
Matioli, M.N.P.S. & Caramelli, P. (2012). NEUROPSI battery subtest profile in subcortical vascular dementia and Alzheimer’s disease. Dementia & Neuropsychologia, 6, 170174.CrossRefGoogle ScholarPubMed
Mattioli, F., Capra, R., Rovaris, M., Chiari, S., Codella, M., Miozzo, A., Gregorini, G., & Filippi, M. (2002). Frequency and patterns of subclinical cognitive impairment in patients with ANCA-associated small vessel vasculitides. Journal Neurological Sciences, 195, 161166.CrossRefGoogle ScholarPubMed
Meade, T., Manolios, N., Cumming, S.R., Conaghan, P.G., & Katz, P. (2018). Cognitive impairment in rheumatoid arthritis: a systematic review. Arthritis Care & Research (Hoboken), 70, 3952.CrossRefGoogle ScholarPubMed
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C.M., & Colantonio, A. (2016). The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Medicine Reviews, 25, 5273.CrossRefGoogle ScholarPubMed
Oldham, M. (2017). Autoimmune encephalopathy for psychiatrists: when to suspect autoimmunity and what to do next. Psychosomatics, 58(3), 228244.CrossRefGoogle Scholar
Ostrosky-Solis, F., Ardila, A., & Rosselli, M. (1999). NEUROPSI: a brief neuropsychological test battery in Spanish with norms by age and educational level. Journal of the International Neuropsychological Society, 5, 413433.CrossRefGoogle ScholarPubMed
Robson, J.C., Dawson, J., Cronholm, P.F., Milman, N., Kellom, K.S., Ashdown, S., Easley, E., Farrar, J.T., Gebhart, D., Lanier, G., McAlear, C.A., Peck, J., Luqmani, R.A., Shea, J.A., Tomasson, G., & Merkel, P.A. (2018). Health-related quality of life in ANCA-associated vasculitis and item generation for a disease-specific patient-reported outcome measure. Patient Related Outcome Measures, 9, 1734.CrossRefGoogle ScholarPubMed
Stone, J.H., Hoffman, G.S., Merkel, P.A., Min, Y.I., Uhlfelder, M.L., Hellmann, D.B., Specks, U., Allen, N.B., Davis, J.C., Spiera, R.F., Calabrese, L.H., Wigley, F.M., Maiden, N., Valente, R.M., Niles, J.L., Fye, K.H., McCune, J.W., St Clair, E.W., & Luqmani, R.A. (2001). A disease specific activity index for Wegener’s granulomatosis: modification of the Birmingham Vasculitis Activity Score. International Network for the Study of the Systemic Vasculitides (INSSYS). Arthritis & Rheumatology, 44, 912920.3.0.CO;2-5>CrossRefGoogle Scholar
Yates, M. & Watts, R. (2017). ANCA-associated vasculitis. Clinical Medicine (London), 17, 6064.CrossRefGoogle ScholarPubMed
Yilmaz, N., Mollahasanoglu, A., Gurvit, H., Can, M., Tuncer, N., Inanc, N., & Yavuz, S. (2012). Dysexecutive syndrome: a specific pattern of cognitive impairment in systemic sclerosis. Cognitive and Behavioral Neurology, 25, 5762.CrossRefGoogle ScholarPubMed
Zigmond, A.S. & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361370.CrossRefGoogle ScholarPubMed