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Impact of pain on cognitive functions in primary Sjögren syndrome with small fiber neuropathy: 10 cases and a literature review.

Abstract Primary Sjögren syndrome (pSS) is a chronic systemic autoimmune disease characterized by xerophthalmia, xerostomia, and potential peripheral or central neurological involvement. In pSS, the prevalence of cognitive disorders is generally sparse across literature and the impact of pain on cognitive profile is unclear. The aim of this study was to determine the relation between pain, cognitive complaint, and impairment in a very homogenous population of 10 pSS patients with painful small fiber neuropathy (PSFN) and spontaneous cognitive complaint. Neurological exam, neuropsychological assessment, clinical evaluation measuring pain level, fatigue, anxiety, depression, and cognitive complaint were performed. Our results showed that 100% of patients had cognitive dysfunction especially in executive domain (80%). The most sensitive test was the Wisconsin Card Sorting Test (WCST), abnormal in 70% of our population. Moreover, we found clear cut significant correlations between pain levels and 3 measures of WCST: the number of errors (R = -0.768, P = .0062), perseverations (R = 0.831, P = .0042), and categories (R = 0.705, P = .02). In the literature review, the impact of pain is underexplored and results could be discordant. In a homogeneous cohort of pSS patients with PSFN, a cognitive complaint seems to be a valid reflection of cognitive dysfunction marked by a specific executive profile found with the WCST. In this preliminary study, this profile is linked to the level of pain and highlights that an appropriate management of pain control and a cognitive readaptation in patients could improve the quality of life.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28422829
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170419
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 16
DP  - 2017 Apr
TI  - Impact of pain on cognitive functions in primary Sjogren syndrome with small
      fiber neuropathy: 10 cases and a literature review.
PG  - e6384
LID - 10.1097/MD.0000000000006384 [doi]
AB  - Primary Sjogren syndrome (pSS) is a chronic systemic autoimmune disease
      characterized by xerophthalmia, xerostomia, and potential peripheral or central
      neurological involvement. In pSS, the prevalence of cognitive disorders is
      generally sparse across literature and the impact of pain on cognitive profile is
      unclear. The aim of this study was to determine the relation between pain,
      cognitive complaint, and impairment in a very homogenous population of 10 pSS
      patients with painful small fiber neuropathy (PSFN) and spontaneous cognitive
      complaint. Neurological exam, neuropsychological assessment, clinical evaluation 
      measuring pain level, fatigue, anxiety, depression, and cognitive complaint were 
      performed. Our results showed that 100% of patients had cognitive dysfunction
      especially in executive domain (80%). The most sensitive test was the Wisconsin
      Card Sorting Test (WCST), abnormal in 70% of our population. Moreover, we found
      clear cut significant correlations between pain levels and 3 measures of WCST:
      the number of errors (R = -0.768, P = .0062), perseverations (R = 0.831, P =
      .0042), and categories (R = 0.705, P = .02). In the literature review, the impact
      of pain is underexplored and results could be discordant. In a homogeneous cohort
      of pSS patients with PSFN, a cognitive complaint seems to be a valid reflection
      of cognitive dysfunction marked by a specific executive profile found with the
      WCST. In this preliminary study, this profile is linked to the level of pain and 
      highlights that an appropriate management of pain control and a cognitive
      readaptation in patients could improve the quality of life.
FAU - Indart, Sandrine
AU  - Indart S
AD  - aCognitive Neurology Center AP-HP, Hopital Lariboisiere bINSERM, U942 cUniversity
      of Paris Diderot, Sorbonne Paris Cite dDepartment of Internal Medicine, AP-HP,
      Hopital Lariboisiere, INSERM eDepartment of Biochemistry and Molecular Biology,
      AP-HP, Hopital Lariboisiere, Paris, France.
FAU - Hugon, Jacques
AU  - Hugon J
FAU - Guillausseau, Pierre Jean
AU  - Guillausseau PJ
FAU - Gilbert, Alice
AU  - Gilbert A
FAU - Dumurgier, Julien
AU  - Dumurgier J
FAU - Paquet, Claire
AU  - Paquet C
FAU - Sene, Damien
AU  - Sene D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
AID - 10.1097/MD.0000000000006384 [doi]
AID - 00005792-201704210-00010 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Apr;96(16):e6384. doi: 10.1097/MD.0000000000006384.

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