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  1. S. Kleinert1,2,
  2. P. Rapp1,
  3. F. Schuch1,
  4. M. Ronneberger1,
  5. J. Wendler1,
  6. P. Sternad3,
  7. F. Popp3,
  8. P. Bartz-Bazzanella4,
  9. C. B. Von der Decken5,
  10. K. Karberg6,
  11. G. Gauler7,
  12. P. Wurth7,
  13. S. Spaethling-Mestekemper8,
  14. C. Kuhn9,
  15. M. Englbrecht10,
  16. W. Vorbrüggen11,
  17. G. Adler12,
  18. M. Welcker3
  1. 1Praxisgemeinschaft Rheumatologie – Nephrologie (, Rheumatology, Erlangen, Germany
  2. 2University Hospital of Würzburg, Department of Internal Medicine II, Rheumatology/Clinical Immunology, Würzburg, Germany
  3. 3Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Rheumatology, Planegg, Germany
  4. 4Rhein-Maas-Klinikum, Klinik für Internistische Rheumatologie, Würselen, Germany
  5. 5Medizinisches Versorgungszentrum für Rheumatologie, Rheumatology, Stolberg, Germany
  6. 6Praxis für Rheumatologie und Innere Medizin, Rheumatology, Berlin, Germany
  7. 7Rheumatology Practice, Rheumatology, Osnabrück, Germany
  8. 8Rheumatologische Gemeinschaftspraxis München, Rheumatology, München, Germany
  9. 9Praxis für Rheumatologie Karlsruhe, Rheumatology, Karlsruhe, Germany
  10. 10Freelance Healthcare Data Scientist, Statistics, Eckental, Germany
  11. 11Verein zur Förderung der Rheumatologie e.V., Rheumatology, Würselen, Germany
  12. 12Institut für Studien zur Psychischen Gesundheit (ISPG), Mannheim, Psychology, Mannheim, Germany


Background: There is some evidence that neuropsychiatric changes occur in systemic lupus(1) and rheumatoid arthritis(2). However, little is known regarding a possible disease-related impairment of cognitive abilities in axial spondyloarthritis (axSpA).

Objectives: To evaluate patients with axSpA regarding cognitive impairments.

Methods: Patients with axSpA attending two rheumatology practices were routinely evaluated by rheumatologists and underwent a computer-based memory and attention test (MAT) (3, 4) with subscale scores ranging from 0 (worst) to 15 (best). The results of short-term memory and working memory were compared to an age-, sex- and education-matched control group of healthy subjects. Descriptive results are presented as median (IQR) for interval data and n (%) for nominal data if not stated otherwise. Two-tailed Wilcoxon signed-rank tests including Bonferroni-Holm adjustment for multiple tests were conducted to investigate the magnitude of potential differences in cognitive abilities.

Results: 101 consecutive patients were tested (Table 1). After multiple testing adjustment for two subscales, Wilcoxon signed-rank tests returned significant findings for working memory (V = 539.5, p = 0.006, |r| = 0.204) but not for short-term memory (V = 1075, p = 0.351, |r| = 0.078). Regarding the scales’ anchors, descriptive results on pairwise differences suggested axSpA patients to have working memory scores that are on average 10.7% lower compared to control participants (mean Δ= -1.64, SD Δ= 5.95).

Table 1.

Patients and disease characteristics

Conclusion: The MAT computerized testing is a feasible test and was well accepted by patients. Results regarding working memory suggest that cognitive abilities needed to accomplish everyday tasks may be impaired in axSpA patients. Further work is needed to characterise possible causes of or associations with this cognitive impairment.

References: [1]Zabala A, Salgueiro M, Saez-Atxukarro O, Ballesteros J, Ruiz-Irastorza G, Segarra R. Cognitive Impairment in Patients With Neuropsychiatric and Non-neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis. J Int Neuropsychol Soc. 2018:1-11.

[2]Vitturi BK, Nascimento BAC, Alves BR, de Campos FSC, Torigoe DY. Cognitive impairment in patients with rheumatoid arthritis. J Clin Neurosci. 2019;69:81-7.

[3]Adler G, Bektas M, Feger M, Lembach Y. [Computer-based assessment of memory and attention: evaluation of the memory and attention test (MAT)]. Psychiatr Prax. 2012;39(2):79-83.

[4]Adler G, Lembach Y. Memory and selective attention in multiple sclerosis: cross-sectional computer-based assessment in a large outpatient sample. Eur Arch Psychiatry Clin Neurosci. 2015;265(5):439-43.

Acknowledgements: This study was funded by the RHADAR GbR (A Network of Rheumatologists), Bahnhofstr. 32, 82152 Planegg, Germany. RHADAR GbR has received a grant for this study from Novartis Pharma GmbH.

Disclosure of Interests: Stefan Kleinert Consultant of: Novartis, Abbvie, Grant/research support from: Novartis, Praxedis Rapp: None declared., Florian Schuch Speakers bureau: Novartis, Abbvie, Gilead, Consultant of: Novartis, Abbvie, Gilead, Monika Ronneberger: None declared., Joerg Wendler Speakers bureau: Roche, Pharma, JanssenCilag, Novartis, Abbvie, Consultant of: JanssenCilag, Patrizia Sternad: None declared., Florian Popp: None declared., Peter Bartz-Bazzanella: None declared., Cay-Benedict von der Decken: None declared., Kirsten Karberg Speakers bureau: Roche, Sanofi, Abbvie, Lilly, Georg Gauler Speakers bureau: Abbvie, Gilead, Novartis, Lilly, Consultant of: Lilly, Gilead, Abbvie, Patrick Wurth Speakers bureau: Abbvie, Lilly, UCB, Medac, Susanna Spaethling-Mestekemper Speakers bureau: Abbvie, BMS, Celgene, Gilead, GSK, Hexal, Lilly, MSD, Novartis, Pfizer, Sanofi, UCB, Christoph Kuhn: None declared., Matthias Englbrecht Speakers bureau: AbbVie, Chugai, Eli Lilly, Novartis, Roche, Sanofi, Mundipharma, Paid instructor for: AbbVie, Chugai, Roche, Consultant of: AbbVie, Novartis, Roche, Sanofi, Grant/research support from: Roche, Chugai, Wolfgang Vorbrüggen: None declared., Georg Adler: None declared., Martin Welcker Speakers bureau: Abbvie, Actelion, Amgen, Biogen,BMS, Berlin Chemie, Celgene, Galapagos, Gilead, GSK, Hexal, Janssen, Medac, MSD, Mundipharma, Mylan, Novartis, Pfizer, Roche, Sanofi, SOBI, UCB, Grant/research support from: Novartis, Abbvie.

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