Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety

Csaba Oláh, Zsófia Kardos, Mónika Andrejkovics, Enikő Szarka, Katalin Hodosi, Andrea Domján, Mariann Sepsi, Attila Sas, László Kostyál, Katalin Fazekas, Ágnes Flórián, Katalin Lukács, Ágnes Miksi, Zsuzsanna Baráth, György Kerekes, Márta Péntek, Attila Valikovics, László Tamási, Dániel Bereczki, Zoltán Szekanecz

Research output: Contribution to journalArticle

Abstract

We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima–media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.

Original languageEnglish
JournalRheumatology International
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Cognition
Rheumatoid Arthritis
Anxiety
Depression
Pathology
Methylenebis(chloroaniline)
Blood Vessels
Equipment and Supplies
Cerebral Arteries
Biological Products
Education
Methotrexate
Trail Making Test
Stroop Test
Doppler Ultrasonography
Victoria
Joint Diseases
Rheumatoid Factor
Blood Sedimentation
Intelligence

Keywords

  • Biological therapy
  • Carotid artery
  • Cerebrovascular disease
  • Cognitive dysfunction
  • Methotrexate
  • Rheumatoid arthritis
  • Transcranial Doppler

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Assessment of cognitive function in female rheumatoid arthritis patients : associations with cerebrovascular pathology, depression and anxiety. / Oláh, Csaba; Kardos, Zsófia; Andrejkovics, Mónika; Szarka, Enikő; Hodosi, Katalin; Domján, Andrea; Sepsi, Mariann; Sas, Attila; Kostyál, László; Fazekas, Katalin; Flórián, Ágnes; Lukács, Katalin; Miksi, Ágnes; Baráth, Zsuzsanna; Kerekes, György; Péntek, Márta; Valikovics, Attila; Tamási, László; Bereczki, Dániel; Szekanecz, Zoltán.

In: Rheumatology International, 01.01.2019.

Research output: Contribution to journalArticle

Oláh, C, Kardos, Z, Andrejkovics, M, Szarka, E, Hodosi, K, Domján, A, Sepsi, M, Sas, A, Kostyál, L, Fazekas, K, Flórián, Á, Lukács, K, Miksi, Á, Baráth, Z, Kerekes, G, Péntek, M, Valikovics, A, Tamási, L, Bereczki, D & Szekanecz, Z 2019, 'Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety', Rheumatology International. https://doi.org/10.1007/s00296-019-04449-8
Oláh, Csaba ; Kardos, Zsófia ; Andrejkovics, Mónika ; Szarka, Enikő ; Hodosi, Katalin ; Domján, Andrea ; Sepsi, Mariann ; Sas, Attila ; Kostyál, László ; Fazekas, Katalin ; Flórián, Ágnes ; Lukács, Katalin ; Miksi, Ágnes ; Baráth, Zsuzsanna ; Kerekes, György ; Péntek, Márta ; Valikovics, Attila ; Tamási, László ; Bereczki, Dániel ; Szekanecz, Zoltán. / Assessment of cognitive function in female rheumatoid arthritis patients : associations with cerebrovascular pathology, depression and anxiety. In: Rheumatology International. 2019.
@article{cee307ea9f5c481682eaca1d5c47c7ce,
title = "Assessment of cognitive function in female rheumatoid arthritis patients: associations with cerebrovascular pathology, depression and anxiety",
abstract = "We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima–media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.",
keywords = "Biological therapy, Carotid artery, Cerebrovascular disease, Cognitive dysfunction, Methotrexate, Rheumatoid arthritis, Transcranial Doppler",
author = "Csaba Ol{\'a}h and Zs{\'o}fia Kardos and M{\'o}nika Andrejkovics and Enikő Szarka and Katalin Hodosi and Andrea Domj{\'a}n and Mariann Sepsi and Attila Sas and L{\'a}szl{\'o} Kosty{\'a}l and Katalin Fazekas and {\'A}gnes Fl{\'o}ri{\'a}n and Katalin Luk{\'a}cs and {\'A}gnes Miksi and Zsuzsanna Bar{\'a}th and Gy{\"o}rgy Kerekes and M{\'a}rta P{\'e}ntek and Attila Valikovics and L{\'a}szl{\'o} Tam{\'a}si and D{\'a}niel Bereczki and Zolt{\'a}n Szekanecz",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00296-019-04449-8",
language = "English",
journal = "Rheumatology International",
issn = "0172-8172",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Assessment of cognitive function in female rheumatoid arthritis patients

T2 - associations with cerebrovascular pathology, depression and anxiety

AU - Oláh, Csaba

AU - Kardos, Zsófia

AU - Andrejkovics, Mónika

AU - Szarka, Enikő

AU - Hodosi, Katalin

AU - Domján, Andrea

AU - Sepsi, Mariann

AU - Sas, Attila

AU - Kostyál, László

AU - Fazekas, Katalin

AU - Flórián, Ágnes

AU - Lukács, Katalin

AU - Miksi, Ágnes

AU - Baráth, Zsuzsanna

AU - Kerekes, György

AU - Péntek, Márta

AU - Valikovics, Attila

AU - Tamási, László

AU - Bereczki, Dániel

AU - Szekanecz, Zoltán

PY - 2019/1/1

Y1 - 2019/1/1

N2 - We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima–media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.

AB - We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima–media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.

KW - Biological therapy

KW - Carotid artery

KW - Cerebrovascular disease

KW - Cognitive dysfunction

KW - Methotrexate

KW - Rheumatoid arthritis

KW - Transcranial Doppler

UR - http://www.scopus.com/inward/record.url?scp=85074024292&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074024292&partnerID=8YFLogxK

U2 - 10.1007/s00296-019-04449-8

DO - 10.1007/s00296-019-04449-8

M3 - Article

C2 - 31555886

AN - SCOPUS:85074024292

JO - Rheumatology International

JF - Rheumatology International

SN - 0172-8172

ER -