Neuropsychiatric manifestations in primary Sjogren syndrome

Appenzeller, Simone; Oliveira, Samuel Andrade de; Bombini, Mariana Freschi; Sepresse, Samara Rosa; Reis, Fabiano; França, Marcondes Cavalcante

doi:10.1080/1744666x.2022.2117159

Cited by 8 publications

(10 citation statements)

References 95 publications

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“…Furthermore, inflammation plays a crucial role in the development of cardiovascular diseases [ 39 ], and it is worth mentioning that SS patients often have comorbid cardiovascular conditions [ 40 ], which are also prevalent in PD patients [ 41 ]. Consequently, it is plausible that the link between SS and PD may be attributed to certain shared inflammatory pathways, as the increase of pro-inflammatory factors in the brain can contribute to the progression of PD and neurodegeneration [ 8 ]. Moreover, the amplified risk of developing PD in SS patients can potentially be explained by discrepancies in lifestyle and nutrition.…”

Section: Discussionmentioning

confidence: 99%

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Sjögren’s syndrome and Parkinson’s Disease: A bidirectional two-sample Mendelian randomization study

Cai,

Jin,

Zhang

et al. 2024

PLoS ONE

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Background Previous observational studies have reported an association between Sjögren’s syndrome (SS) and an increased risk of Parkinson’s Disease (PD). However, the causal relationship between these conditions remains unclear. The objective of this study was to investigate the causal impact of SS on the risk of developing PD, utilizing the Mendelian randomization (MR) approach. Methods We conducted a bidirectional MR analysis using publicly available genome-wide association studies (GWAS) data. The primary analysis utilized the inverse-variance weighted (IVW) method. Complementary methods, such as MR-Egger regression, weighted mode, weighted median, and MR-pleiotropy residual sum and outlier (MR-PRESSO), were utilized to identify and correct for the presence of horizontal pleiotropy. Results The IVW MR analysis revealed no significant association between SS and PD (IVW: OR = 1.00, 95% CI = 0.94–1.07, P = 0.95). Likewise, the reverse MR analysis did not identify any significant causal relationship between PD and SS (IVW: OR = 0.98, 95% CI = 0.85–1.12, P = 0.73). The results from MR-Egger regression, weighted median, and weighted mode approaches were consistent with the IVW method. Sensitivity analyses suggested that horizontal pleiotropy is unlikely to introduce bias to the causal estimates. Conclusion This study does not provide evidence to support the assertion that SS has a conclusive impact on the risk of PD, which contradicts numerous existing observational reports. Further investigation is necessary to determine the possible mechanisms behind the associations observed in these observational studies.

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Section: Discussionmentioning

confidence: 99%

“…The infiltration of lymphocytes and immunoreactive proteins into the nervous system can lead to a variety of neurological impairments [ 7 ]. For instance, research findings indicate that approximately 31% of individuals diagnosed with SS experience nervous system impairment [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Sjögren’s syndrome and Parkinson’s Disease: A bidirectional two-sample Mendelian randomization study

Cai,

Jin,

Zhang

et al. 2024

PLoS ONE

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“…The management of neuropsychiatric involvement in Sjögren’s syndrome lacks well-established guidelines, relying only on limited data derived from small case series and experiences with other autoimmune diseases [ 8 ] . Early treatment with corticosteroids and immunosuppressive agents could rapidly improve symptoms and prevent complications [ 8 ] .…”

Section: Discussionmentioning

confidence: 99%

“…She reported profound fatigue, constant depressive mood, anhedonia, difficulty concentrating, anorexia with weight loss and hypersomnia, without any other accompanying systemic rituximab, two patients were on methylprednisolone and rituximab, and one patient received methylprednisolone, intravenous immunoglobulins, rituximab, intravenous plasmapheresis and cyclophosphamide, with favourable outcomes observed in all four patients. The management of neuropsychiatric involvement in Sjögren's syndrome lacks well-established guidelines, relying only on limited data derived from small case series and experiences with other autoimmune diseases [8] . Early treatment with corticosteroids and immunosuppressive agents could rapidly improve symptoms and prevent complications [8] .…”

Section: Case Descriptionmentioning

confidence: 99%

Refractory depressive disorder as the first manifestation of adolescent Sjögren’s syndrome, successfully treated with rituximab

El-Ouakhoumi,

Joulal,

Yousfi

et al. 2024

European Journal of Case Reports in Internal Medicine

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Background: The psychiatric manifestations of Sjögren’s syndrome are often overlooked despite their prevalence. They can be revelatory of the disease and include anxiety, depression, dementia and, rarely, psychosis. Case description: We report a case of 18-year-old female in whom a major depressive syndrome revealed primary Sjögren’s disease, with a favourable outcome after treatment with rituximab. Conclusion: The diagnostic of Sjögren’s syndrome should be considered in patients who present with unexplained and refractory neuropsychiatric symptoms, even in the absence of sicca symptoms.

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“…Symptomatic treatment options include cognitive rehabilitation, antidepressant and anxiolytic medications, and pain management. Immunomodulatory therapies, such as corticosteroids, disease-modifying antirheumatic drugs, and biologic agents, should also be considered for patients [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Psychiatric Manifestations of Primary Sjögren’s Syndrome: A Narrative Review

Salehi,

Zamiri,

Kim

et al. 2024

International Journal of Rheumatology

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Background. Primary Sjögren’s syndrome (pSS) is recognized for its autoimmune origin. Its hallmark symptoms, dry eyes and mouth, result from glandular inflammation. Prior literature indicates that pSS not only affects the peripheral system but also involves the central nervous system (CNS), giving rise to various neuropsychiatric symptoms. However, there is limited published research on the psychiatric comorbidities in individuals with pSS. Methods. A comprehensive search was conducted on PubMed and Google Scholar for this narrative review. The search spanned from inception until August 2023. Its aim was to locate studies focusing on the psychiatric manifestations of pSS and the potential underlying mechanisms. Results. The most commonly reported psychiatric complications among these individuals are depression and cognitive dysfunction. Other psychiatric manifestations that have been reported in pSS individuals include anxiety, sleep disorders, psychosis, catatonia, bipolar disorder, and obsessive-compulsive disorder. Conclusion. In conclusion, patients with pSS often display multiple psychiatric symptoms. These symptoms can significantly impair functioning and reduce quality of life. Hence, prompt diagnosis and management are crucial.

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Neuropsychiatric manifestations in primary Sjogren syndrome

Cited by 8 publications

References 95 publications

Sjögren’s syndrome and Parkinson’s Disease: A bidirectional two-sample Mendelian randomization study

Sjögren’s syndrome and Parkinson’s Disease: A bidirectional two-sample Mendelian randomization study

Refractory depressive disorder as the first manifestation of adolescent Sjögren’s syndrome, successfully treated with rituximab

Exploring the Psychiatric Manifestations of Primary Sjögren’s Syndrome: A Narrative Review

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