Disease activity and cognition in rheumatoid arthritis

an open label pilot study

Graham Raftery, Jiabao He, Ruth Pearce, Daniel Birchall, Julia L Newton, Andrew M Blamire, John D Isaacs

Research output: Contribution to journalArticle

13 Citations (Scopus)
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Abstract

ABSTRACT: INTRODUCTION: We hypothesised that fatigue in rheumatoid arthritis (RA) is related to TNF-alpha induced dysregulation of cerebral blood flow. Our objectives were to assess fatigue, cognitive function and cerebral blood flow before and after initiation of anti-TNF treatment. METHODS: In a pilot study, 15 patients initiating treatment with adalimumab were assessed for fatigue using a visual analogue scale (FACIT-F), cognitive function using a panel of psychometric tests and regional cerebral blood flow using MR perfusion imaging. RESULTS: Patients improved clinically after anti-TNF therapy in terms of DAS28 and FACIT-F. Furthermore significant improvements were documented in full scale, verbal and performance IQ following therapy. There was a non-significant trend towards reduced cerebral perfusion in both grey and white matter, and fatigue at 3 months correlated with cerebral blood flow in white (p = 0.014) and grey (p = 0.005) matter. CONCLUSIONS: We demonstrate for the first time a significant improvement in cognitive function following effective treatment of RA. Although we observed minor reductions in cerebral blood flow, and a correlation between cerebral blood flow and fatigue, a larger, controlled study would be required to affirm a causal relationship.
Original languageEnglish
Article numberR263
Number of pages6
JournalArthritis Research & Therapy
Volume14
DOIs
Publication statusPublished - 4 Dec 2012

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Cerebrovascular Circulation
Cognition
Rheumatoid Arthritis
Fatigue
Therapeutics
Perfusion Imaging
Regional Blood Flow
Visual Analog Scale
Psychometrics
Tumor Necrosis Factor-alpha
Perfusion

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Raftery, G., He, J., Pearce, R., Birchall, D., Newton, J. L., Blamire, A. M., & Isaacs, J. D. (2012). Disease activity and cognition in rheumatoid arthritis: an open label pilot study. Arthritis Research & Therapy, 14, [R263]. https://doi.org/10.1186/ar4108

Disease activity and cognition in rheumatoid arthritis : an open label pilot study. / Raftery, Graham; He, Jiabao; Pearce, Ruth; Birchall, Daniel; Newton, Julia L; Blamire, Andrew M; Isaacs, John D.

In: Arthritis Research & Therapy, Vol. 14, R263, 04.12.2012.

Research output: Contribution to journalArticle

Raftery, G, He, J, Pearce, R, Birchall, D, Newton, JL, Blamire, AM & Isaacs, JD 2012, 'Disease activity and cognition in rheumatoid arthritis: an open label pilot study', Arthritis Research & Therapy, vol. 14, R263. https://doi.org/10.1186/ar4108
Raftery, Graham ; He, Jiabao ; Pearce, Ruth ; Birchall, Daniel ; Newton, Julia L ; Blamire, Andrew M ; Isaacs, John D. / Disease activity and cognition in rheumatoid arthritis : an open label pilot study. In: Arthritis Research & Therapy. 2012 ; Vol. 14.
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abstract = "ABSTRACT: INTRODUCTION: We hypothesised that fatigue in rheumatoid arthritis (RA) is related to TNF-alpha induced dysregulation of cerebral blood flow. Our objectives were to assess fatigue, cognitive function and cerebral blood flow before and after initiation of anti-TNF treatment. METHODS: In a pilot study, 15 patients initiating treatment with adalimumab were assessed for fatigue using a visual analogue scale (FACIT-F), cognitive function using a panel of psychometric tests and regional cerebral blood flow using MR perfusion imaging. RESULTS: Patients improved clinically after anti-TNF therapy in terms of DAS28 and FACIT-F. Furthermore significant improvements were documented in full scale, verbal and performance IQ following therapy. There was a non-significant trend towards reduced cerebral perfusion in both grey and white matter, and fatigue at 3 months correlated with cerebral blood flow in white (p = 0.014) and grey (p = 0.005) matter. CONCLUSIONS: We demonstrate for the first time a significant improvement in cognitive function following effective treatment of RA. Although we observed minor reductions in cerebral blood flow, and a correlation between cerebral blood flow and fatigue, a larger, controlled study would be required to affirm a causal relationship.",
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N2 - ABSTRACT: INTRODUCTION: We hypothesised that fatigue in rheumatoid arthritis (RA) is related to TNF-alpha induced dysregulation of cerebral blood flow. Our objectives were to assess fatigue, cognitive function and cerebral blood flow before and after initiation of anti-TNF treatment. METHODS: In a pilot study, 15 patients initiating treatment with adalimumab were assessed for fatigue using a visual analogue scale (FACIT-F), cognitive function using a panel of psychometric tests and regional cerebral blood flow using MR perfusion imaging. RESULTS: Patients improved clinically after anti-TNF therapy in terms of DAS28 and FACIT-F. Furthermore significant improvements were documented in full scale, verbal and performance IQ following therapy. There was a non-significant trend towards reduced cerebral perfusion in both grey and white matter, and fatigue at 3 months correlated with cerebral blood flow in white (p = 0.014) and grey (p = 0.005) matter. CONCLUSIONS: We demonstrate for the first time a significant improvement in cognitive function following effective treatment of RA. Although we observed minor reductions in cerebral blood flow, and a correlation between cerebral blood flow and fatigue, a larger, controlled study would be required to affirm a causal relationship.

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