AB0662 Frequencies of cognitive impairment and vitamin d deficiency and determination of apoe allells in the patients with fibromyalgia syndrome
Authors: U. Bilge, N. S. Yasar Bilge, I. Unluoglu, D. Ozbabalik, M. Ipek, T. Kasifoglu, E. Gonullu, C. Korkmaz
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder. (1). Neurologic symptoms including memory decline, mental confusion and cognitive impairment have been frequently seen in FMS (2,3). There is a positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function and low levels of vitamin D were seen in fibromyalgia patients (4,5). <h3>Objectives</h3> Our aim was to evaluate the levels of 25-OH-Vitamin D and cognitive functions and their relationships in patients with FMS. <h3>Methods</h3> Montreal Cognitive Assessment (MOCA), Mini-Mental State Examination (MMSE) were performed for evaluation of cognitive functions and Vit-D levels were obtained. Scores lower than 26 were considered as cognitive impairment for both MOCA and MMSE. Magnetic resonance imaging findings and rates of single-nucleotide polymorphisms, 3 within the <i>APOE</i> gene (E2, E3, E4) were considered after neurological examination. <h3>Results</h3> Forty patients (39 women, 1 man with a median age of 48.33±1.11) were enrolled in the study. Memory deterioration was found in 29 (%73) of patients. Cognitive dysfunction was found in %15 according to MMSE scores and %30 according to MOCA scores. A total of 18 MRI studies were performed and %56 of patients have positive findings. Nine of 18 patients have ischemic lesions according to MRI findings. A total of 29 patients' APOE polymorphism were considered and one of them has ApoE2 allel, one of them has E4/E4 allel, 4 of them have Apo E3/E4 allel, and 21 of them have E3/E3 allels. Sixteen patients (%40) have Vitamin D deficiency. We did not find any correlations between cognitive test scores and Vitamin D levels. <h3>Conclusions</h3> According to the study by Myers et al. ; the cumulative incidence of Alzheimer's (AD) increased in a dose dependent fashion where 55% of the ApoE E4/E4 subjects developed AD by age 80, compared with 27% of the ApoE E3/E4 and 9% of the ApoE E3/E3 subjects by age 85 years (6). Prospective studies may be helpfull for the relationship between FMS, cognitive impairment and ApoE allels and vitamin D. <h3>References</h3> -Mease P: Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatol Suppl 2005, 75:6-21 -Rodríguez-Andreu J, Ibáñez-Bosch R, Portero-Vázquez A, Masramon X, Rejas J, Gálvez R.Cognitive impairment in patients with fibromyalgia syndrome as assessed by the mini-mental state examination. BMC Musculoskelet Disord. 2009 Dec 21;10:162. doi: 10.1186/1471-2474-10-162. -Leavitt F, Katz RS, Mills M, Heard AR.Cognitive and dissociative manifestations in fibromyalgia. J Clin Rheumatol. 2002 Apr;8(2):77-84. -Lu'o'ng KV, Nguyên LT. The beneficial role of vitamin D in Alzheimer's disease. Am J Alzheimers Dis Other Demen. 2011 Nov;26(7):511-20. -Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB.Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol. 2007 Apr;26(4):551-4. Epub 2006 Jul 19. -Myers RH, Schaefer EJ, Wilson PW, D'Agostino R, Ordovas JM, Espino A, Au R, White RF, Knoefel JE, Cobb JL, McNulty KA, Beiser A, Wolf PA.Apolipoprotein E epsilon4 association with dementia in a population-based study: The Framingham study. Neurology. 1996 Mar;46(3):673-7. <h3>Disclosure of Interest</h3> None Declared