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

doi:10.1186/ar4108

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 journal › Article › peer-review

21 Citations (Scopus)

6 Downloads (Pure)

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 language	English
Article number	R263
Number of pages	6
Journal	Arthritis Research & Therapy
Volume	14
DOIs	https://doi.org/10.1186/ar4108
Publication status	Published - 4 Dec 2012

Access to Document

10.1186/ar4108Licence: CC BY

art%3A10.1186%2Far4108
© 2012 Raftery et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Final published version, 167 KBLicence: CC BY

Cite this

@article{beeafd7d92ee48e39c728a00de2a3dc1,

title = "Disease activity and cognition in rheumatoid arthritis: an open label pilot study",

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.",

author = "Graham Raftery and Jiabao He and Ruth Pearce and Daniel Birchall and Newton, {Julia L} and Blamire, {Andrew M} and Isaacs, {John D}",

note = "Acknowledgements This work was supported in part by NIHR Newcastle Biomedical Research Centre. Funding for this study was provided by Abbott Laboratories. Abbott Laboratories were not involved in study design; in the collection, analysis and interpretation of data; or in the writing of the report.",

year = "2012",

month = dec,

day = "4",

doi = "10.1186/ar4108",

language = "English",

volume = "14",

journal = "Arthritis Research & Therapy",

issn = "1478-6354",

publisher = "BioMed Central",

}

TY - JOUR

T1 - Disease activity and cognition in rheumatoid arthritis

T2 - an open label pilot study

AU - Raftery, Graham

AU - He, Jiabao

AU - Pearce, Ruth

AU - Birchall, Daniel

AU - Newton, Julia L

AU - Blamire, Andrew M

AU - Isaacs, John D

N1 - Acknowledgements This work was supported in part by NIHR Newcastle Biomedical Research Centre. Funding for this study was provided by Abbott Laboratories. Abbott Laboratories were not involved in study design; in the collection, analysis and interpretation of data; or in the writing of the report.

PY - 2012/12/4

Y1 - 2012/12/4

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.

AB - 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.

U2 - 10.1186/ar4108

DO - 10.1186/ar4108

M3 - Article

C2 - 23211089

VL - 14

JO - Arthritis Research & Therapy

JF - Arthritis Research & Therapy

SN - 1478-6354

M1 - R263

ER -

Disease activity and cognition in rheumatoid arthritis: an open label pilot study

Abstract

Access to Document

Fingerprint

Cite this