FRI0343 Cognitive disorders in behÇet's disease: some clinical and pathogenesis relations

Abstract

Background: the cognitive disorders (CD) is a special psychopathological problem for Behçet's Disease (BD) patients. The causes of CD aren't enough investigated. Anxiety/depressive disorders and primary neural parenchymal lesions due to BD usually related to CD in these patients. Objectives: to determine the prevalence of CD in BD patients and its associations with some clinical and magnetic resonance imaging (MRI) scan features. Methods: the investigation has been realized in accordance with the interdisciplinary program “Stress factors and mental disorders in immune-mediated inflammatory rheumatic diseases”. 106 BD patients were enrolled in the study. The majority of patients were men (72,6%), natives of the North Caucasus (51,9%), with mean age (M±m) 33,3±0,98 years. All the patients met the criteria of the International Study Group for BD (1990) classification. The disease activity was assessed by scoring system BDCAF. CD were diagnosed with psychology and neuropsychology methods. Mental disorders (MD) were diagnosed by psychiatrist in accordance with the ICD-10 in semi-structured interview. The severity of depression and anxiety was evaluated by Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). Brain MRI including T1- weighted images, T2- weighted images and fluidattenuated inversion-recovery images (FLAIR) was done in 44 (41,5%) BD patients. Results: CD of mild to moderate severity were diagnosed in 82 (77,4%) of BD patients. The mechanical memory (50%) and attention deficit (80,5%) were the most frequent manifestations of CD, impairment of associative memory (31,7%) and logical thinking (36,6%) were less frequent. The presence of CD didn't depend on BD activity, severity and duration, as on patient's ethnicity, use of prednisone and immunosupressive agents. The frequency of neurological manifestations (headache, seizures, myelopathy, ataxia) did not differ significantly in patients with and without CD (28% vs 32%, p=0,44). The patients with CD were older (34,3±1,07 vs 29,0±2,14, p=0,006), more often had chronic/recurrent depressive disorders (84,1% vs 50,0%, p=0,001) of moderate severity (MADRS 16,1±0,74 vs 12,2±1,06, p=0,005), chronic stressful life events (91,5% vs 62,5%, p=0,001) and multifocal subcortical parenchymal MRI changes (57,6% vs 9%, p=0,005). Conclusions: the results have shown high rates of different CD in BD patients. CD were not associated with BD activity and presence of neurological symptoms. CD were related to the diagnoses of stress-related mild to moderate chronic depressive disorders and minor brain multifocal subcortical parenchymal MRI lesions.