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001-es BibID:BIBFORM081586
Első szerző:Oláh Csaba (idegsebész)
Cím: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 Marianna, 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
Dátum:2020
ISSN:0172-8172 1437-160X
Megjegyzések: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.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Rheumatoid arthritis
Cognitive dysfunction
Cerebrovascular disease
Transcranial Doppler
Carotid artery
Methotrexate
Biological therapy
Megjelenés:Rheumatology International. - 40 : 4 (2020), p. 529-540. -
További szerzők:Kardos Zsófia Andrejkovics Mónika (1967-) (klinikai szakpszichológus, neuropszichológus, pszichoterapeuta) Szarka Enikő Hódosi Katalin Domján Andrea (1979-) (jogász, egészségügyi menedzser) Sepsi Marianna Sas Attila Kostyál László (1974-) (radiológus) Fazekas Katalin (orvos) Flórián Ágnes Lukács Katalin Miksi Ágnes Baráth Zsuzsa Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Péntek Márta Valikovics Attila Tamási László Bereczki Dániel (1960-) (neurológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Pályázati támogatás:TAMOP-4.2.4.A/2-11/1-2012-0001
TÁMOP
GINOP-2.3.2-15-2016-00050
GINOP
GINOP-2.3.2-15-2016-00015
GINOP
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001-es BibID:BIBFORM070695
Első szerző:Oláh Csaba (idegsebész)
Cím:Assessment of intracranial vessels in association with carotid atherosclerosis and brain vascular lesions in rheumatoid arthritis / Csaba Oláh, Zsófia Kardos, Mariann Sepsi, Attila Sas, László Kostyál, Harjit Pal Bhattoa, Katalin Hodosi, György Kerekes, László Tamási, Attila Valikovics, Dániel Bereczki, Zoltán Szekanecz
Dátum:2017
ISSN:1478-6354 1478-6362
Megjegyzések:Background: Stroke has been associated with rheumatoid arthritis (RA). We assessed patients with RA and healthycontrol subjects by transcranial Doppler (TCD), carotid ultrasonography and brain magnetic resonance imaging (MRI).Methods: Altogether, 41 female patients with RA undergoing methotrexate (MTX) or biologic treatment and 60age-matched control subjects underwent TCD assessment of the middle cerebral artery (MCA) and basilar artery.Pulsatility index (PI), resistivity (resistance) index (RI) and circulatory reserve capacity (CRC) were determined at rest (r)and after apnoea (a) and hyperventilation (h). The presence of carotid plaques and carotid intima-media thickness(cIMT) were also determined. Intracerebral vascular lesions were investigated by brain MRI.Results: MCA PI and RI values at rest and after apnoea were significantly increased in the total and MTX-treated RApopulations vs control subjects. MCA CRC was also impaired, and basilar artery PI was higher in RA. More patientswith RA had carotid plaques and increased cIMT. Linear regression analysis revealed that left PI(r) and RI(r) correlatedwith disease duration and that left PI(r), RI(r), PI(a), PI(h) and basilar PI correlated with disease activity. Right CRCinversely correlated with 28-joint Disease Activity Score. Disease activity was an independent determinant of left PI(a)and right CRC. Compared with long-term MTX treatment alone, the use of biologics in combination with MTX wasassociated with less impaired cerebral circulation. Impaired cerebral circulation was also associated with measures ofcarotid atherosclerosis.Conclusions: To our knowledge, this is the first study to show increased distal MCA and basilar artery occlusion in RAas determined by TCD. Patients with RA also had CRC defects. We also confirmed increased carotid plaque formationand increased cIMT. Biologics may beneficially influence some parameters in the intracranial vessels.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Arthritis Research & Therapy 19 : 1 (2017), p. 213. -
További szerzők:Kardos Zsófia Sepsi Marianna Sas Attila Kostyál László (1974-) (radiológus) Bhattoa Harjit Pal (1973-) (laboratóriumi szakorvos) Hódosi Katalin Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Tamási László Valikovics Attila Bereczki Dániel (1960-) (neurológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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DOI
Intézményi repozitóriumban (DEA) tárolt változat
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