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Crohn's patients show mild cognitive impairment
Patients with Crohn’s disease showed mild cognitive impairment compared with healthy controls in an observational study, which researchers linked to systemic inflammation, symptom burden and poor sleep quality.
“These results reinforce the notion that Crohn’s has a wide range of multi-systemic consequences with the impact of the disease affecting patients not only within but well beyond the digestive tract,” Daniel R. van Langenberg, MD, head of IBD Service at Eastern Health and senior lecturer at Monash University in Victoria, Australia, said in a press release. “The findings appear consistent with experiments that have shown that bowel inflammation results in an upregulation of inflammatory hippocampus activity in the brain. This, in turn, might account for the slower response times that were observed in the study.”
van Langenberg and colleagues recruited 49 patients with Crohn’s disease (median age, 44 years) and 31 healthy age- and sex-matched controls, who completed the Subtle Cognitive Impairment Test (SCIT), a 4-minute test requiring participants to decide which of two lines briefly presented on a computer screen is shorter. SCIT response time served as the primary endpoint of the study.
Participants also completed surveys detailing clinical, demographic, psychiatric, fatigue and sleep quality data, and their disease activity was assessed based on serum C-reactive protein, fecal calprotectin and Harvey-Bradshaw Index scores. The investigators used multiple linear regression to determine factors associated with slower SCIT response time.
Crohn’s patients showed significantly slower SCIT response times compared with controls (P < .001), and serum C-reactive protein, abdominal pain, plasma hemoglobin and concurrent fatigue were all independently associated with slower SCIT response times in Crohn’s patients (P < .05 for each). There was also a trend for poorer sleep quality linked to slower SCIT response times in Crohn’s patients, while higher fecal calprotectin was significantly associated with faster SCIT response times (P < .01).
“This research highlights the need for regular interventions with multi-disciplinary IBD teams to address the wide issues that are presented with Crohn’s disease,” Gigi Veereman, MD, PhD, United European Gastroenterology Public Affairs Committee member and Secretary General of ESPGHAN, said in the press release. “This will enable a greater understanding of this complex condition and therefore improve the service and care offered to each patient.” – by Adam Leitenberger
Disclosures: van Langenberg reports speaker funding and/or consulting for AbbVie, Janssen, Shire, Ferring, Fresenius Kabi and Takeda, and has received research funding from AbbVie, Shire, Orphan Australia and Ferring during the conduct of the study. Please see the full study for a list of all other researchers’ relevant financial disclosures.