Background Neuro-Behçet’s disease (NBD) may present cognitive and behavioral symptoms, such as pseudobulbar affect, personality disorders and memory impairment. Because of its predilection for brainstem and basal ganglia, explanations for cognitive/behavioral deficits were related to a secondary dysfunction of frontal and temporal cortices due to damage of subcortical structures. Nontheless, patients without overt neurological manifestation may present cognitive impairment.
Objectives Cognitive functioning in Brazilian NBD and Behçet’s disease (BD) patients, and its relation with cumulative prednisone dose, systemic disease activity and white matter lesions were evaluated.
Methods Brain MRI white-matter lesions and neuropsychological battery scores of NBD patients (NBDG), BD patients without overt neurological manifestation (BDG) and control (CON) groups, each one with 24 subjects, were compared. Hamilton Anxiety Scale (HAM), Beck Depression Inventory (BDI) was applied to all subjects. White-matter lesions were evaluated according to the age-related white matter changes scale.
Results BDG and NBDG patients were impaired in language and executive function. Visual memory was impaired only in NBDG patients. Neuropsychological scores did not differ between active and non-active patients and did not correlate with cumulative prednisone dose. Also, multiple logistic regressions disclosed that neuropsychological scores were not related to age, gender, white-matter lesions, HAM or BDI. However higher educational level was associated to inferior risk of cognitive impairment (OR 0.77, 95% CI 0.62-0.96, p=0.021).
Conclusions Patients with BD without overt neurological manifestation may present cognitive impairment, which does not relate to disease activity, white-matter lesions or cumulative prednisone dose. Low educational level is a risk factor for cognitive impairment in BD.
Disclosure of Interest None Declared
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