Yao WANG, Zhiwei ZUO, Ying SHI, et al. Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis[J]. Journal of Third Military Medical University, 2018, 40(5): 426-430.
DOI:
Yao WANG, Zhiwei ZUO, Ying SHI, et al. Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis[J]. Journal of Third Military Medical University, 2018, 40(5): 426-430. DOI: 10.16016/j.1000-5404.201710029.
Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis
To investigate the changes of cortical thickness and cortical surface area in rheumatoid arthritis (RA) patients
and explore the relationship of these changes with cognitive impairment.
Methods
2
A total of 50 RA patients admitted in the Department of Integrated Chinese and Western Medicine of our hospital from October 2016 to May 2017 were enrolled in this study. Another 40 healthy volunteers matched with sex
age and educational level served as control. All subjects underwent 3D-T
1
WI scanning. The original 3D-T
1
WI brain images were analyzed with Freesurfer software
and the values of cortical thickness and surface area were extracted for the difference between the 2 groups. Correlation and regression analyses were used to determine the factors that affect the changes of cortical abnormalities with cognitive scores.
Results
2
The analysis on 3D-T
1
WI images showed that compared to the control group
the RA group had significantly decreased cortical thickness in left pars opercularis of inferior frontal gyrus
left superior frontal gyrus
left rostral middle frontal gyrus
right precentral gyrus
and right para-hippocampal gyrus (
P
<
0.05)
and obviously declined cortical surface area in postcentral gyrus (
P
<
0.05). The total scores of MoCA and MMSE
visuospatial/executive
attention
language
delayed recall and orientation were significant reduced in the RA group than the control (
P
<
0.05). After adjustmen
t for age
educational level
course of disease
stepwise regression analysis indicated that right para-hippocampal cortical thickness were positively correlated with delayed recall score
right precentral cortex thickness and total scores of MoCA
language and visuospatial/executive function (
P
<
0.05).
Conclusion
2
The RA patients have significantly decreases in cortical thickness and surface areas
and are accompanied by cognitive impairment. The changes of some cortex thickness are obviously associated with cognitive impairment.
关键词
Keywords
references
JEFFERY R C. Clinical features of rheumatoid arthritis[J]. Medicine, 2010, 38(4):167-171. DOI: 10.1016/j.mpmed.2009.12.004.
Ungprasert P, Wijarnpreecha K, Thongprayoon C. Rheumatoid arthritis and the risk of dementia: A systematic review and meta-analysis[J]. Neurol India, 2016, 64(1): 56-61.DOI: 10.4103/0028-3886.173623.
JULIAN L J, YAZDANY J, TRUPIN L, et al . Validity of brief screening tools for cognitive impairment in rheumatoid arthritis and systemic lupus erythematosus[J ] . Arthritis CareRes, 2012, 64(3):448-454. DOI: 10.1002/acr.21566.
ALETAHA D, NEOGI T, SILMAN A J, et al . 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J ] . Arthritis Rheum, 2010. 62(9): 2569-2581.DOI: 10.1002/art.27584.
BIZZO B C, SANCHEZ T A, TUKAMOTO G, et al . Cortical thickness and episodic memory impairment in systemic lupus erythematosus[J ] . J Neuroimaging, 2017, 27(1):122-127.DOI:10.1111/jon.12394.
ZHAO L, TAN X, WANG J, et al . B rain white matter structural networks in patients with non-neuropsychiatric systemic lupus erythematosus[J ] . Brain Imaging Behav, 2017.. DOI: 10.1007/s11682-017-9681-3.
WARTOLOWSKA K, HOUGH MG, JENKINSON M, et al . Structural changes of the brain in rheumatoid arthritis[J ] . Arthritis Rheum, 2012, 64(2): 371-379. DOI: 10.1002/art.33326.
BARTOLINI M, CANDELA M, BRUGNI M, et al . Are behaviour and motor performances of rheumatoid arthritis patients influenced by subclinical cognitive impairments? A clinical and neuroimaging study[J ] . Clin Exp Rheumatol, 2002, 20(4):491-497.
MAKRIS N, BIEDERMAN J, VALERA EM, et al .Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder[J ] . Cereb Cortex, 2007, 17(6):1364-1375. DOI: 10.1093/cercor/bhl047.
FUNAHASHI S, ANDREAU J M. Prefrontal cortex and neural mechanisms of executive function[J].J Physiol Paris, 2013, 107(6): 471-482. DOI: 10.1016/j.jphysparis.2013.05.001.
BALCONI M. Dorsolateral prefrontal cortex, working memory and episodic memory processes: insight through transcranial magnetic stim-ulationtechniques[J]. Neurosci Bull, 2013, 29(3): 381-389. DOI: 10.1007/s12264-013-1309-z.
MILLER E K, COHEN J D. An integrative theory of prefrontal cortex function[J]. Ann Rev Neurosci, 2001, 24(1): 167-202. DOI: 10.1146/annurev.neuro.24.1.167.
KOENIGS M, GRAFMAN J. The functional neuroanatomy of depression: distinct roles for ventromedial and dorsolateral prefrontal cortex[J]. Behav Brain Res, 2009, 201(2): 239-243. DOI: 10.1016/j.bbr.2009.03.004.
APKARIAN A V, SOSA Y, SONTY S, et al . Chronic back pain is associated with decreased prefrontal and thalamic gray matter density[J ] . J Neurosci, 2004, 24(46): 10410-10415. DOI: 10.1523/JNEUROSCI.2541-04.2004.
PAMUK O N, KISACIK B, PAMUK G E, et al . Do impaired memory, cognitive dysfunction and distress play a role in methotrexate-related neutropenia in rheumatoid arthritis patients? A comparative study[J ] . Rheumatol Int, 2013, 33(10):2631-2635. DOI: 10.1007/s00296-013-2792-2.
BARKER G R, BANKS P J, SCOTT H, et al . Separate elements of episodic memory subserved by distinct hippocampal-prefront al connections[J ] . Nat Neurosci, 2017, 20(2):242-250. DOI:10.1038/nn.4472.
AFSHARI N A, AFSHARI M A, FOSTER C S. Inflammatory conditions of the eye associated with rheumatic diseases[J]. Curr Rheumatol Rep, 2001, 3(5): 453-458. DOI: 10.1007/s11926-996-0017-3.