Cognitive Function of Patients with Crohnʼs Disease is Associated with Intestinal Disease Activity

Golan, Daniel; Gross, Bella; Miller, David H.; Klil-Drori, Sivan; Lavi, Idit; Shiller, Moshe; Honigman, Silvia; Almog, Ronit; Segol, Ori

doi:10.1097/mib.0000000000000594

Cited by 20 publications

(17 citation statements)

References 52 publications

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“…Thus, the MS cohort did appear to experience lower cognitive functioning compared to the other disease cohorts, though not necessarily at a level that met a formal threshold for impairment. Previous studies have also reported deficits in processing speed in IBD, 30 and deficits in verbal memory in IBD and RA, in keeping with our findings. 12,31 Working memory was the only cognitive domain examined in the current study in which elevated rates of impairment were not seen.…”

Section: Discussionsupporting

confidence: 93%

“…29 The CVLT-II assesses the capacity to learn and remember verbal information, the LNS assesses working memory capacity, and the SDMT assesses processing speed. These measures were chosen to assess cognitive domains commonly reported as affected in those with MS, IBD, RA, 4,[30][31][32] and anxiety and depression disorders. 21 The Wechsler Test of Adult Reading (WTAR) 33 was included to estimate premorbid (i.e., relatively resistant to brain disease) cognitive functioning, based on single word reading.…”

Section: Methodsmentioning

confidence: 99%

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Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

et al. 2019

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ObjectiveTo determine whether anxiety and depression are associated with cognition in multiple sclerosis (MS), and whether these associations are similar in other immune-mediated inflammatory diseases (IMID; including inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) and in anxious/depressed individuals (ANX/DEP) without an IMID.MethodsParticipants (MS: n = 255; IBD: n = 247; RA: n = 154; ANX/DEP: n = 308) completed a structured psychiatric interview, the Hospital Anxiety and Depression Scale, and cognitive testing, including the Symbol Digit Modalities Test, the California Verbal Learning Test, and Letter Number Sequencing test. Test scores were converted to age-, sex-, and education-adjusted z scores. We evaluated associations of anxiety and depression with the cognitive z scores using multivariate linear models, adjusting for disease cohort.ResultsAll cohorts exhibited higher rates of impairment (i.e., z less than or equal to −1.5) in the domains of processing speed, verbal learning, and delayed recall memory relative to general population norms. Higher levels of anxiety symptoms were associated with slower processing speed, lower verbal learning, and lower working memory performance (all p < 0.001); higher levels of depression symptoms were associated with slower processing speed. These associations did not differ across cohorts.ConclusionAnxiety and depression are associated with lower cognitive function in MS, with a similar pattern observed in persons with other IMID, including IBD and RA, and persons without an IMID. Managing symptoms of anxiety and of depression in MS, as well as other IMIDs, is important to mitigate their effect on cognition.

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Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

et al. 2019

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“…The interconnectivity of the brain‐gut axis is further suggested as IBD symptoms correlate to stress, which in turn correlates to changes in the hypothalamic‐pituitary‐adrenal axis, prefrontal amygdaloid complex, and CRFergic system . Furthermore, significant associations between markers of CD progression, cognitive dysfunction, and stress levels have been described in patients with CD . One particular study, which compared asymptomatic IBD adolescent patients to their control counterparts, suggested that those with IBD tended to have lower grade point averages and more difficulty in some areas of school functioning compared to healthy youth .…”

Section: Introductionmentioning

confidence: 99%

“…2,7 Furthermore, significant associations between markers of CD progression, cognitive dysfunction, and stress levels have been described in patients with CD. 8 One particular study, which compared asymptomatic IBD adolescent patients to their control counterparts, suggested that those with IBD tended to have lower grade point averages and more difficulty in some areas of school functioning compared to healthy youth. 9 Adult patients with IBD have also demonstrated lower verbal IQ scores compared to healthy controls (HCs), as well as controls with IBS, predicting that the disease process of IBD could be responsible for these effects.…”

Section: Introductionmentioning

confidence: 99%

A Verbal Fluency Task‐Based Brain Activation fMRI Study in Patients with Crohn's Disease in Remission

Nair

Dodd

Rajan

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE In this pilot study, we investigated functional brain activation changes in patients with Crohn's disease (CD) in remission compared to age and gender‐matched healthy controls (HCs). METHODS Data from 20 patients with CD in remission (age range 19‐63 years) and 20 HCs (matched in age and gender) were analyzed. Task functional MRI (fMRI) data were collected while participants performed a cognitive (phonemic verbal fluency) task in the scanner. All participants also performed the same task outside the scanner. RESULTS Task fMRI results showed greater bi‐hemispheric activation in CD patients compared to controls. Because this pattern is commonly reported with normal aging, we performed further analyses to investigate fMRI responses in a subset of the younger CD patients (N = 12, age < = 35 years) compared to matched young HCs (age < = 35 years), and an older cohort of HCs (age > = 50 years). Results showed that task activation patterns were similar between young CD patients and older HCs, and that both groups differed significantly from younger HCs. Activation intensity in specific brain regions for patients was associated with disease duration. CONCLUSIONS These results suggest that CD patients in remission may show accelerated signs of aging in terms of brain responses to a typical cognitive task. Future work with larger sample size will need to replicate these results as well as investigate the influence of factors, such as chronicity of the disease and medication effects on task‐associated brain activation patterns in this patient population.

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“…A study by Golan et al . found declines in verbal function and data processing speed compared to the normative data of healthy subjects 16 . Langenberg et al .…”

Section: Discussionmentioning

confidence: 76%

Impaired neurocognitive and psychomotor performance in patients with inflammatory bowel disease

Hadjina

Živković

Matetić

et al. 2019

Sci Rep

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Limited evidence exists regarding cognitive and psychomotor function in patients with inflammatory bowel disease (IBD). Therefore, we aimed to compare the neurocognitive and psychomotor function of 60 IBD patients with 60 age/sex-matched controls. Computer-based instrument Complex Reactinometer Drenovac (CRD) was used for assessment of cognitive domains: convergent thinking (simple mathematical tasks; CRD-11), perceptive abilities (light signal position discrimination; CRD-311) and sophisticated operative thinking (complex psychomotor coordination; CRD-411). The most important analyzed parameters were total test solving time (TTTS); minimal time of particular test solving (TMIN) and total number of wrong reactions (NER). Performance in all three cognitive tests showed statistically significantly longer TTTS and TMIN in IBD patients (P < 0.05), while there was no significant difference in NER. Aforementioned findings were adjusted for BMI, age and duration of education. Our study has shown impaired neurocognitive and psychomotor function in IBD patients compared to controls, especially in mental processing speed and mental endurance of perceptive abilities, convergent thinking and complex operative thinking.

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Cognitive Function of Patients with Crohnʼs Disease is Associated with Intestinal Disease Activity

Abstract: Cognitive performance is related to CD activity and nutritional status. The results provide insight into potential influence of nutrition and inflammation on cognitive function. Further studies on cognitive function of patients with CD are warranted.

Cited by 20 publications

References 52 publications

Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

A Verbal Fluency Task‐Based Brain Activation fMRI Study in Patients with Crohn's Disease in Remission

Impaired neurocognitive and psychomotor performance in patients with inflammatory bowel disease

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