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A7.7 Cognitive dysfunctions in patients with rheumatoid arthritis
  1. S Monov1,
  2. R Shumnalieva1,
  3. D Monova2,
  4. R Rashkov1,
  5. Ek Chamurliiska3
  1. 1Clinic of Rheumatology – Medical University, Sofia
  2. 2Medical Institude – MVR, Sofia
  3. 3Private Practice, Sofia

Abstract

Background Rheumatoid arthritis (Rheumatoid Arthritis - RA) is a systemic, autoimmune, chronic inflammatory disease which involves mainly the musculoskeletal system in form of erosive arthritis (synovitis). According to different authors the incidence of extraarticular manifestations in RA is around 10–20%. The involvement of the central nervous system is rare in patients with RA and could be explained both by the disease itself (vasculitis, rheumatoid nodules, amyloidosis) or the treatment.

The introduction of modern instrumental methods for investigation (hsCT, MRI, PET, SPECT) and tests for cognitive dysfunctions offers an opportunity for discovering the variety of neuropsychiatric disorders in patients with RA.

Methods and Materials 96 patients with RA in the age range between 31 and 56 (mean 39.18 ± 6.13 years) were included in the study, of whom 78 were females and 18 – males with disease duration for 3 to 11 years (mean 5.45 ±1.6 years). Clinical tests for detecting cognitive dysfunctions were performed by a clinical psychologist to all patients. For excluding a possible cognitive dysfunction due to the corticosteroid treatment, the cognitive dysfunction of the patients with RA was compared with 225 patients with SLE, treated with corticosteroids and with the cognitive dysfunctions of 63 otherwise healthy individuals.

Results In none of the patients there was a history for cognitive dysfunctions (memory, attention, thinking). Latent cognitive dysfunction was detected in 23 RA patients (23,96 %) with predominant disorders in the memory (47.83%).

Conclusion Our study shows that the cognitive dysfunctions are significantly (p < 0,001) more common in RA patients (23.96%) than in healthy individuals (17.46%), and, on the other hand, that the cognitive dysfunction in SLE patients (64.44%) is more demonstrative in comparison with RA patients independently of the long lasting steroid treatment in both groups (with similar data for the mean duration of the treatment and the mean dose of the drug).

Keywords rheumatoid arthritis, extraarticular manifestations, cognitive dysfunctions

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