Article Text

PDF
SAT0473 Alterations in Cerebral Perfusion in Patients with Systemic Sclerosis and Cognitive Impairment
  1. O. Veralastra,
  2. J. Moreno-Gutierrez,
  3. M.D.P. Cruz Dominguez
  1. Internal Medicine, Hospital Especialidades CMN La Raza. Instituto Mexicano Seguro Social, Mexico City, Mexico

Abstract

Background Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by fibrosis, immunological and vascular abnormalities. Cerebral hypoperfusion can be caused by microvascular cerebral ischemia. Cognitive impairment (CI) are a major cause of morbidity in SSc.

Objectives To estimate the frequency of CI in SSc patients and alterations in cerebral perfusion (CP).

Methods We studied 88 patients with SSc. The Montreal Test (MT) was given to all patients to evaluate CI. To 15 patients with CI and without systemic hypertension, diabetes mellitus, cerebrovascular disease, vasculitis, hypothyroidism, depression, and drugs that interfere with the cognitive assessment, the CP was measured by cerebral gammagram (CG).

Results Of the 88 woman patients with SSc, 58 (66%) had CI by MT. The CP was decreased in 12 of 15 (80%) patients. The mean age of patient with CI was 45.9±10.5 vs patients without CI 43.1±14.1 (p<0.05), the mean disease evolution of SSc with CI was 12.9±9.8 vs without CI 5.67±4.9 years (p<0.01) and 12 of 15 patients had the diffuse variety. A decrease in CP was observed in following lobes: frontal in 9 of 15 (60%) patients, temporal in 7 of 15 (46%), and parietal in 3 of 15 (20%). Concordance between MT and CG was 60% for the frontal, 46% for the temporal and 13% for the parietal lobes.

Conclusions The CI is common in SSc. A decrease in CP was more frequent in the frontal lobe, predominating in older patients and with longer duration of SSc. It is important to investigate if vasodilators treatment could improve the CP.

References

  1. Giuliodori G1, Fraticelli P, Bartolini M, Cagnetti C, Baruffaldi R, Rocchi MB, Provinciali L, Gabrielli A, Silvestrini M. Cognitive and cerebral hemodynamic impairment in scleroderma patients. Eur J Neurol. 2009;16(12):1285-90.

  2. Cutolo M, Nobili F, Sulli A, Pizzorni C, Briata M, Faelli F, Vitali P, Mariani G, Copello F, Seriolo B, Barone C, Rodriguez G. Evidence of cerebral hypoperfusion in scleroderma patients. Rheumatology (Oxford). 2000; 39(12):1366-73.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.