Cognitive and cerebral hemodynamic impairment in scleroderma patients

  1. G. Giuliodori1,
  2. P. Fraticelli2,
  3. M. Bartolini1,
  4. C. Cagnetti1,
  5. R. Baruffaldi1,
  6. M. B. L. Rocchi3,
  7. L. Provinciali1,
  8. A. Gabrielli2,
  9. M. Silvestrini1

Article first published online: 15 JUN 2009

DOI: 10.1111/j.1468-1331.2009.02714.x

Issue

European Journal of Neurology

European Journal of Neurology

Volume 16, Issue 12, pages 1285–1290, December 2009

Additional Information

How to Cite

Giuliodori, G., Fraticelli, P., Bartolini, M., Cagnetti, C., Baruffaldi, R., Rocchi, M. B. L., Provinciali, L., Gabrielli, A. and Silvestrini, M. (2009), Cognitive and cerebral hemodynamic impairment in scleroderma patients. European Journal of Neurology, 16: 1285–1290. doi: 10.1111/j.1468-1331.2009.02714.x

Author Information

  1. 1

    Neuroscience Department, Neurological Clinic, Marche Polytechnic University, Ancona, Italy

  2. 2

    Medical-Surgical Sciences Department, Medical Clinic, Marche Polytechnic University, Ancona, Italy

  3. 3

    Section of Medical Statistics, DISUAN, University of Urbino, Urbino, Italy

*Prof. Mauro Silvestrini, Clinica Neurologica, Università Politecnica delle Marche, Azienda Ospedaliera Ospedali Riuniti, Via Conca 1, 60020 Torrette di Ancona (AN), Italy (tel.: +39 071 5964532; fax: +39 071 887262; e-mail: m.silvestrini@univpm.it).

Publication History

  1. Issue published online: 17 NOV 2009
  2. Article first published online: 15 JUN 2009
  3. Received 20 January 2009 Accepted 7 May 2009

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Keywords:

  • cerebral hemodynamics;
  • cognition;
  • systemic sclerosis;
  • transcranial Doppler

Background and purposes:  Neurological involvement in systemic sclerosis is unusual despite the possible cerebral localization of vascular lesions. The aim of this study was to evaluate cognitive performances and cerebral vasoreactivity in young scleroderma patients without any signs or symptoms of nervous system involvement.

Methods:  Sixteen scleroderma patients and 16 sex- and age-matched healthy subjects without vascular risk factors were included. A neuropsychological assessment for the evaluation of different areas of cognition was performed. For an assessment of cerebrovascular reactivity (CVR), each subject was submitted to hypercapnia with transcranial Doppler ultrasonography using the Breath-Holding Index (BHI).

Results:  Patients had significantly lower adjusted mean levels of performance with respect to controls in the Modified Card Sorting Test (P < 0.001) and in the Trail Making Test Parts A and B (P < 0.001 and P < 0.05 respectively). Regarding CVR, BHI values were significantly lower in patients with respect to controls: 0.82 ± 0.44 vs. 1.34 ± 0.18, P < 0.0001.

Conclusions:  These findings show the presence of reduced performances of executive functions in scleroderma patients. The associated alteration of CVR in the absence of other apparent causes of cerebrovascular impairment suggests that cognitive problems may be related to an alteration in cerebral perfusion regulation specifically linked to the disease. Further studies are needed to evaluate whether cognitive changes may be positively influenced by treatments aimed to improve vessels functionality in scleroderma patients.

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