Subclinical neurological involvement in Behcet′s disease

Tunç, Tuğba; Ortapamuk, Hulya; Naldöken, Seniha; Ergün, Ufuk; Cılız, Deniz; Atasoy, H. Tuğrul; Okuyucu, Esra; İnan, Levent Ertuğrul; Ekşioğlu, Meral

doi:10.4103/0028-3886.28116

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…However, we should be cautious in the interpretation of these results because not all Behçet's disease patients underwent MRI examination and no healthy demographically matched neuroimaging data were obtained. Nonetheless, the prevalence of impairments in laboratory studies was consistent with those reported by previous series 18,19,22 . Patients with abnormal findings on neuropsychological and/or neuroradiological studies, but with normal neurological examination and with no neurological complaints except for tension‐type headache and/or migraine, may represent a subset of what has been called silent CNS involvement 3,4 …”

Section: Discussionsupporting

confidence: 85%

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Cognitive Functioning in Behçet's Disease

Cavaco

Silva

Pinto

et al. 2009

Annals of the New York Academy of Sciences

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The impact of Behçet's disease on higher cognitive functions is still poorly understood. We proposed (1) to characterize the neuropsychological profile of Behçet's disease patients with (Neuro-BD) and without (BD) neurological manifestations; (2) to identify which clinical, psychopathological, and genetic variables are related to neuropsychological performance; and (3) to explore the association between cognitive functioning and neuroimaging findings in BD patients. Fifteen Neuro-BD and 35 BD patients in the nonactive phase of their illness underwent a neurological examination, performed a comprehensive battery of neuropsychological tests, and answered the hospital anxiety and depression scale. Human leukocyte antigen (HLA)-B*51 genotyping was also performed. Patients' neuropsychological performances were compared to those of healthy demographically matched subjects. Within one month from the testing date, a subset of 20-BD patients underwent a magnetic resonance imaging (MRI) scan. Fifty-three percent of Neuro-BD and 40% of BD patients were impaired at least on one neuropsychological measure (i.e., digit span-forward). Poorer cognitive functioning in Neuro-BD was associated with parenchymal involvement, whereas in BD it was related to presence of white matter changes in the frontal lobes, history of headache complaints, or higher levels of anxiety and depression. Current prednisone intake had a positive impact on neuropsychological performance. Disease duration, time since onset of neurological manifestations, or presence of HLA-B*51 allele had no significant influence. Our results indicate that Behçet's disease may affect cognitive abilities in the absence of overt neurological symptoms. These findings point to an insidious course of neurological involvement.

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Section: Discussionsupporting

confidence: 85%

“…Subclinical neurological abnormalities have been detected in neuroradiological, 6,13,18,19 neurophysiological, 19–21 or neuropsychological 6,22 examinations of 27–75% of Behçet's disease patients without overt neurological manifestations. However, negative findings have also been reported 17,23,24 .…”

Section: Introductionmentioning

confidence: 99%

Cognitive Functioning in Behçet's Disease

Cavaco

Silva

Pinto

et al. 2009

Annals of the New York Academy of Sciences

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“…There is a tendency for CVST to occur earlier in disease course compared to the parenchymal type of CNS disease and this difference is significant in male patients [99]. In the pediatric age group affected with BS, the neurologic involvement is mostly in the form of CVST (unpublished observation).…”

Section: ■ Extra-axial Nbsmentioning

confidence: 92%

“…The detection of abnormalities on neurophysiological studies, as well as by neuroimaging in asymptomatic patients further suggests that the subgroup of patients with subclinical CNS and PNS involvement may not be so uncommon [99]. However, the clinical and prognostic value of detecting abnormalities in such diagnostic studies in this subgroup of patients currently is still not clear.…”

Section: ■ Subclinical Nbsmentioning

confidence: 94%

The spectrum of nervous system involvement in Behçet’s syndrome and its differential diagnosis

2009

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Behçet's Syndrome (BS) is a multi-system, vascular-inflammatory disease of unknown origin, involving the nervous system in a subgroup of patients. The growing clinical and imaging evidence suggests that primary neurological involvement in BS may be subclassified into two major forms: the first one, which is seen in the majority of patients, may be characterized as a vascular-inflammatory central nervous system (CNS) disease, with focal or multifocal parenchymal involvement mostly presenting with a subacute brainstem syndrome and hemiparesis; the other, which has few symptoms and a better neurological prognosis, may be caused by isolated cerebral venous sinus thrombosis and intracranial hypertension. These two types rarely occur in the same individual, and their pathogenesis is likely to be different. Isolated behavioral syndromes and peripheral nervous system involvement are rare, whereas a nonstructural vascular type headache is relatively common and independent from neurological involvement. Neurologic complications secondary to systemic involvement of BS such as cerebral emboli from cardiac complications of BS and increased intracranial pressure due to superior vena cava syndrome, as well as neurologic complications related to BS treatments such as CNS neurotoxicity with cyclosporine and peripheral neuropathy with the use of thalidomide or colchisin are considered as secondary neurological complications of this syndrome. As the neurological involvement in this syndrome is so heterogeneous, it is difficult to predict its course and prognosis, and response to treatment. Currently, treatment options are limited to attack and symptomatic therapies with no evidence for the efficacy of any long term preventive treatment.

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“…[34][35][36][37][38][39][40][41] Numerous EEG studies addressing neurosyphilis, neuro-Behcet's, xeroderma pigmentosum and lipoid proteinosis later followed. [42][43][44][45] In the early 1990s, MEG was used to map the somatosensory cortex, [46] investigate central itch/pain processing [47][48][49] and brain activity in epidermal nevus syndrome. [50] In 1994, the first dermatology-related study using positron emission tomography (PET) was published.…”

Section: Functional Neuroimaging In Dermatology and The Rise Of Funmentioning

confidence: 99%

Functional magnetic resonance imaging in dermatology: The skin, the brain and the invisible

Mueller

Hogg

Mueller

et al. 2017

Experimental Dermatology

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Subclinical neurological involvement in Behcet′s disease

Abstract: Early diagnosis of neurological involvement in BD is important in reducing or preventing complications. Cranial MRI and EEG were found to be useful for detecting subclinical neurological abnormalities in patients with Behçet's disease.

Cited by 8 publications

References 8 publications

Cognitive Functioning in Behçet's Disease

Cognitive Functioning in Behçet's Disease

The spectrum of nervous system involvement in Behçet’s syndrome and its differential diagnosis

Functional magnetic resonance imaging in dermatology: The skin, the brain and the invisible

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