Cognitive Function in Primary Sjögren's Syndrome: A Systematic Review.
Identifieur interne : 000277 ( Main/Exploration ); précédent : 000276; suivant : 000278Cognitive Function in Primary Sjögren's Syndrome: A Systematic Review.
Auteurs : Ciro Manzo [Italie] ; Eva Martinez-Suarez [Espagne] ; Melek Kechida [Tunisie] ; Marco Isetta [Royaume-Uni] ; Jordi Serra-Mestres [Royaume-Uni]Source :
- Brain sciences [ 2076-3425 ] ; 2019.
Abstract
BACKGROUND
Cognitive disorders are reported to be common in patients with primary Sjogren's syndrome (pSS). In some cases, they are the first clinical manifestation, preceding the diagnosis of pSS by two years on average.
AIM
A systematic review was conducted to explore cognitive impairment in pSS, with reference to diagnostic methods and their relationship with laboratory data and clinical manifestations.
MATERIALS AND METHODS
According to the PRISMA 2009 checklist, we carried out a comprehensive literature search in the three main bibliographic databases: MEDLINE, EMBASE, and PsycINFO (NICE HDAS interface). The following main search terms were used: primary Sjogren syndrome, neurological manifestations, fatigue, cognitive functions, psychiatric manifestations, mild cognitive impairment, dementia, and neurocognitive disorder. The search was made on 14 September, 2018. References from all selected studies were also examined. Inclusion criteria were: all studies and case-reports published in any language from 2002 that assessed the association of pSS (according to classification criteria proposed by the 2002 American/European collaborative group (AECG)) with all types of cognitive impairment (including dementia). Exclusion criteria were: reviews, abstracts, secondary Sjögren's syndrome (SS), and all articles in which other classification criteria were used.
RESULTS
The initial search yielded 352 articles, of which 253 were excluded based on the title and abstract review. A total of 54 articles underwent a full-length review, and 32 articles were excluded. Data were extracted from 18 studies and three case-reports involving a total of 6196 participants. In most cases, cognitive dysfunction was a brain fog or a mild cognitive impairment (MCI). Occasionally, an autoimmune dementia was present. The relationship between pSS and degenerative dementias, such as Alzheimer's disease (AD), was a controversial issue, even if some investigators hypothesized that pSS could be a risk factor. Several unmet needs were highlighted. First, some of the included studies had not reported the severity of pSS; hence, few correlations between disease severity and cognitive function were possible. Secondly, the evaluation of the pathogenetic role of comorbid diseases was often absent. The lack of information on the type of dementia represented a third critical point in the majority of the included studies.
CONCLUSIONS
This systematic review confirmed that adequate studies on cognitive function in pSS are scarce, mostly performed on small-sized samples, and often conflicting. The routine assessment of cognitive function in patients with pSS seems advisable and it will help to elucidate some of the unmet needs highlighted by this review in future appropriately designed studies.
DOI: 10.3390/brainsci9040085
PubMed: 30991679
PubMed Central: PMC6523842
Affiliations:
Links toward previous steps (curation, corpus...)
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Cognitive Diseases and Dementias, Azienda Sanitaria Locale Napoli 3 sud, 80038 Pomigliano d'Arco, Italy. cirmanzo@libero.it.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Center for Cognitive Diseases and Dementias, Azienda Sanitaria Locale Napoli 3 sud, 80038 Pomigliano d'Arco</wicri:regionArea><wicri:noRegion>80038 Pomigliano d'Arco</wicri:noRegion></affiliation></author><author><name sortKey="Martinez Suarez, Eva" sort="Martinez Suarez, Eva" uniqKey="Martinez Suarez E" first="Eva" last="Martinez-Suarez">Eva Martinez-Suarez</name><affiliation wicri:level="3"><nlm:affiliation>Geriatrician, Hospital de Mataró (Barcelona), 08304 Mataró, Barcelona, Spain. emartinezsu@csdm.cat.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Geriatrician, Hospital de Mataró (Barcelona), 08304 Mataró, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Kechida, Melek" sort="Kechida, Melek" uniqKey="Kechida M" first="Melek" last="Kechida">Melek Kechida</name><affiliation wicri:level="1"><nlm:affiliation>Internal Medicine and Endocrinology Department, Fattouma Bourguiba University Hospital, University of Monastir, 5000 Monastir, Tunisia. kechida_mel_lek@hotmail.com.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Internal Medicine and Endocrinology Department, Fattouma Bourguiba University Hospital, University of Monastir, 5000 Monastir</wicri:regionArea><wicri:noRegion>5000 Monastir</wicri:noRegion></affiliation></author><author><name sortKey="Isetta, Marco" sort="Isetta, Marco" uniqKey="Isetta M" first="Marco" last="Isetta">Marco Isetta</name><affiliation wicri:level="1"><nlm:affiliation>Library and Knowledge Services, Central and North West London NHS Foundation Trust, London UB8 3NN, UK. marco.isetta@nhs.net.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Library and Knowledge Services, Central and North West London NHS Foundation Trust, London UB8 3NN</wicri:regionArea><wicri:noRegion>London UB8 3NN</wicri:noRegion></affiliation></author><author><name sortKey="Serra Mestres, Jordi" sort="Serra Mestres, Jordi" uniqKey="Serra Mestres J" first="Jordi" last="Serra-Mestres">Jordi Serra-Mestres</name><affiliation wicri:level="1"><nlm:affiliation>Department of Old Age Psychiatry, Central and North West London NHS Foundation Trust, London UB8 3NN, UK. jordi.serra-mestres@nhs.net.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Old Age Psychiatry, Central and North West London NHS Foundation Trust, London UB8 3NN</wicri:regionArea><wicri:noRegion>London UB8 3NN</wicri:noRegion></affiliation></author></analytic><series><title level="j">Brain sciences</title><idno type="ISSN">2076-3425</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Cognitive disorders are reported to be common in patients with primary Sjogren's syndrome (pSS). In some cases, they are the first clinical manifestation, preceding the diagnosis of pSS by two years on average.</p></div><div type="abstract" xml:lang="en"><p><b>AIM</b></p><p>A systematic review was conducted to explore cognitive impairment in pSS, with reference to diagnostic methods and their relationship with laboratory data and clinical manifestations.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>According to the PRISMA 2009 checklist, we carried out a comprehensive literature search in the three main bibliographic databases: MEDLINE, EMBASE, and PsycINFO (NICE HDAS interface). The following main search terms were used: primary Sjogren syndrome, neurological manifestations, fatigue, cognitive functions, psychiatric manifestations, mild cognitive impairment, dementia, and neurocognitive disorder. The search was made on 14 September, 2018. References from all selected studies were also examined. Inclusion criteria were: all studies and case-reports published in any language from 2002 that assessed the association of pSS (according to classification criteria proposed by the 2002 American/European collaborative group (AECG)) with all types of cognitive impairment (including dementia). Exclusion criteria were: reviews, abstracts, secondary Sjögren's syndrome (SS), and all articles in which other classification criteria were used.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The initial search yielded 352 articles, of which 253 were excluded based on the title and abstract review. A total of 54 articles underwent a full-length review, and 32 articles were excluded. Data were extracted from 18 studies and three case-reports involving a total of 6196 participants. In most cases, cognitive dysfunction was a brain fog or a mild cognitive impairment (MCI). Occasionally, an autoimmune dementia was present. The relationship between pSS and degenerative dementias, such as Alzheimer's disease (AD), was a controversial issue, even if some investigators hypothesized that pSS could be a risk factor. Several unmet needs were highlighted. First, some of the included studies had not reported the severity of pSS; hence, few correlations between disease severity and cognitive function were possible. Secondly, the evaluation of the pathogenetic role of comorbid diseases was often absent. The lack of information on the type of dementia represented a third critical point in the majority of the included studies.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>This systematic review confirmed that adequate studies on cognitive function in pSS are scarce, mostly performed on small-sized samples, and often conflicting. The routine assessment of cognitive function in patients with pSS seems advisable and it will help to elucidate some of the unmet needs highlighted by this review in future appropriately designed studies.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">30991679</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>29</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2076-3425</ISSN><JournalIssue CitedMedium="Print"><Volume>9</Volume><Issue>4</Issue><PubDate><Year>2019</Year><Month>Apr</Month><Day>15</Day></PubDate></JournalIssue><Title>Brain sciences</Title><ISOAbbreviation>Brain Sci</ISOAbbreviation></Journal><ArticleTitle>Cognitive Function in Primary Sjögren's Syndrome: A Systematic Review.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">E85</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.3390/brainsci9040085</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Cognitive disorders are reported to be common in patients with primary Sjogren's syndrome (pSS). In some cases, they are the first clinical manifestation, preceding the diagnosis of pSS by two years on average.</AbstractText><AbstractText Label="AIM" NlmCategory="OBJECTIVE">A systematic review was conducted to explore cognitive impairment in pSS, with reference to diagnostic methods and their relationship with laboratory data and clinical manifestations.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">According to the PRISMA 2009 checklist, we carried out a comprehensive literature search in the three main bibliographic databases: MEDLINE, EMBASE, and PsycINFO (NICE HDAS interface). The following main search terms were used: primary Sjogren syndrome, neurological manifestations, fatigue, cognitive functions, psychiatric manifestations, mild cognitive impairment, dementia, and neurocognitive disorder. The search was made on 14 September, 2018. References from all selected studies were also examined. Inclusion criteria were: all studies and case-reports published in any language from 2002 that assessed the association of pSS (according to classification criteria proposed by the 2002 American/European collaborative group (AECG)) with all types of cognitive impairment (including dementia). Exclusion criteria were: reviews, abstracts, secondary Sjögren's syndrome (SS), and all articles in which other classification criteria were used.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The initial search yielded 352 articles, of which 253 were excluded based on the title and abstract review. A total of 54 articles underwent a full-length review, and 32 articles were excluded. Data were extracted from 18 studies and three case-reports involving a total of 6196 participants. In most cases, cognitive dysfunction was a brain fog or a mild cognitive impairment (MCI). Occasionally, an autoimmune dementia was present. The relationship between pSS and degenerative dementias, such as Alzheimer's disease (AD), was a controversial issue, even if some investigators hypothesized that pSS could be a risk factor. Several unmet needs were highlighted. First, some of the included studies had not reported the severity of pSS; hence, few correlations between disease severity and cognitive function were possible. Secondly, the evaluation of the pathogenetic role of comorbid diseases was often absent. The lack of information on the type of dementia represented a third critical point in the majority of the included studies.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This systematic review confirmed that adequate studies on cognitive function in pSS are scarce, mostly performed on small-sized samples, and often conflicting. The routine assessment of cognitive function in patients with pSS seems advisable and it will help to elucidate some of the unmet needs highlighted by this review in future appropriately designed studies.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Manzo</LastName><ForeName>Ciro</ForeName><Initials>C</Initials><Identifier Source="ORCID">0000-0002-4800-1817</Identifier><AffiliationInfo><Affiliation>Rheumatologic Outpatient Clinic and Gerontorheumatology Service, "Mariano Lauro" Hospital, 80065 Sant'Agnello, Italy. cirmanzo@libero.it.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Cognitive Diseases and Dementias, Azienda Sanitaria Locale Napoli 3 sud, 80038 Pomigliano d'Arco, Italy. cirmanzo@libero.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martinez-Suarez</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Geriatrician, Hospital de Mataró (Barcelona), 08304 Mataró, Barcelona, Spain. emartinezsu@csdm.cat.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kechida</LastName><ForeName>Melek</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-5110-6329</Identifier><AffiliationInfo><Affiliation>Internal Medicine and Endocrinology Department, Fattouma Bourguiba University Hospital, University of Monastir, 5000 Monastir, Tunisia. kechida_mel_lek@hotmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Isetta</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Library and Knowledge Services, Central and North West London NHS Foundation Trust, London UB8 3NN, UK. marco.isetta@nhs.net.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Serra-Mestres</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0003-1935-7109</Identifier><AffiliationInfo><Affiliation>Department of Old Age Psychiatry, Central and North West London NHS Foundation Trust, London UB8 3NN, UK. jordi.serra-mestres@nhs.net.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>04</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Brain Sci</MedlineTA><NlmUniqueID>101598646</NlmUniqueID><ISSNLinking>2076-3425</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">brain fog</Keyword><Keyword MajorTopicYN="N">cognitive functions</Keyword><Keyword MajorTopicYN="N">dementia</Keyword><Keyword MajorTopicYN="N">fatigue</Keyword><Keyword MajorTopicYN="N">mild cognitive impairment</Keyword><Keyword MajorTopicYN="N">primary Sjögren’s syndrome</Keyword><Keyword MajorTopicYN="N">systematic 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