Subtle Cognitive Changes Observed in Systemic Sclerosis Patients
Overview
Patients with systemic sclerosis (SSc) exhibit subtle differences in specific cognitive domains, particularly executive functions, without evidence of global cognitive impairment. Additionally, higher anxiety levels were noted in SSc patients compared to healthy controls.
Background
Systemic sclerosis is a chronic autoimmune disease that may affect multiple organ systems, including the central nervous system. Cognitive impairment in autoimmune diseases is an area of growing interest, with prior studies focusing on global cognitive decline. This study aimed to evaluate cognitive performance across specific domains in patients with SSc compared to rheumatoid arthritis patients and healthy controls.
Data Highlights
| Measure | SSc (n=30) | RA (n=40) | Controls (n=30) |
|---|---|---|---|
| Mean MoCA Score | Not significantly different across groups | Not significantly different | Not significantly different |
| Percentage scoring below MoCA threshold (26) | 53% | Not reported | Not reported |
| TMT-B Completion Time (seconds) | 114 | 96 | 68 |
| WAIS Error Rates | Higher than controls | Comparable to SSc | Lower than SSc |
| Anxiety (STAI Trait) | Higher than controls | Comparable to SSc | Lower than SSc |
| Depression (BDI Scores) | Similar to controls | Not reported | Similar to SSc |
Key Findings
- Global cognitive performance measured by MoCA was similar across SSc, RA, and healthy controls.
- 53% of SSc patients scored below the conventional MoCA threshold for normal cognition.
- SSc patients required significantly more time to complete executive function tasks (e.g., TMT-B) compared to controls and RA patients.
- SSc patients showed longer completion times on Stroop-based tasks and made more errors on WAIS processing speed tasks than controls.
- Anxiety levels, particularly trait anxiety, were higher in SSc patients compared to healthy controls, while depression scores were similar.
- Cognitive performance correlated with age, sex, alcohol intake, interstitial lung disease, and antinuclear antibody positivity but not with depression or anxiety scores.
Clinical Implications
Clinicians should be aware that patients with systemic sclerosis may experience subtle impairments in executive cognitive functions despite normal global cognitive screening results. Elevated anxiety levels in these patients warrant attention and may require targeted management. Routine cognitive screening in SSc might benefit from including domain-specific assessments to detect subtle deficits.
Conclusion
This study suggests that systemic sclerosis is associated with subtle domain-specific cognitive changes, particularly in executive functions, rather than global cognitive impairment. Higher anxiety levels are also characteristic of SSc patients compared to healthy controls.
Related Resources & Content
- Szekanecz et al. 2024 -- SSc May Be Linked to Subtle Cognitive Changes
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