AB0844 EXAMINING THE RELATIONSHIP BETWEEN NEUROCOGNITIVE MANIFESTATIONS AND SJÖGREN’S SYMPTOMS
Authors: M. Elbahnasawi, B. Little, J. Casement, J. Berry, P. Gallagher, W. F. Ng
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Sjögren's Disease (SjD) can cause neuropsychological manifestations and cognitive dysfunction, however the relationship between these manifestations and other extra-glandular manifestations such as fatigue, anxiety and depression is unclear. Clarity around the factors influencing extra glandular manifestations such as fatigue as well as a better understanding of the interplay between cognitive dysfunction, fatigue, depression and anxiety is vital for the development of tailored assessment and management of SJD patients <h3>Objectives:</h3> To examine the relationship between neurocognitive measures and other SJD symptoms of physical fatigue, mental fatigue, depression and anxiety To add to the literature available on neurocognitive measures in SJD patients <h3>Methods:</h3> As part of a larger study, 102 SJD patients were recruited, and EULAR Sjögren Syndrome Patient Reported Index (ESSPRI) was performed on four study visits (V1-4). Patients filled in a diary four times a day for seven days between V1-2 and V3-4, which captured the severity of their symptoms on a 11-point (0-10) Likert scale. Neurocognitive tests were carried out on V1 and V3, six to eight weeks apart, and were used to calculate composites of cognitive processing and attention time, executive function, immediate verbal memory, verbal memory learning, delayed recall, inhibition of executive function, working memory and verbal fluency. Correlation matrices of Pearson R were used to show significant correlations between the composite neurocognitive measures and the weekly and daily SJD symptoms of physical fatigue, mental fatigue, depression and anxiety. The mean diary scores for the day on which V1 and V3 were conducted were used in the correlation analysis. Scatterplots were drawn in R for the significant composite-symptom combinations with the individual patient dots coloured by their Newcastle Sjögren's Stratification Tool (NSST) subgroup (Figure 1). Multiple linear regression was performed in R to find the best models to relate the SJD symptoms and neurocognitive composites (Figure 2). <h3>Results:</h3> Overall, only weak correlations were seen ranging from r = -0.3 to r = 0.28 between the neurocognitive tests and the diary scores. Verbal fluency tested in V1 showed significant negative correlations with fatigue, mental fatigue, depression and anxiety diary scores on the day of V1, and with fatigue on V3. T-tests performed on FisherZ transformed correlation coefficients showed no significant difference between the Pearson R of the different NSST subtypes for the significant composite-symptom combinations. Linear regression using symptoms as the independent variables and neurocognitive composites, age and gender as the dependent variables produced the best models for fatigue and mental fatigue on V1 and V3, as shown by the higher adjusted R squared value in Figure 2. Fatigue and mental fatigue were best explained by a positive correlation with cognitive processing and attention time, measured using a digital symbol substitution task (DSST), and a negative correlation with age. <h3>Conclusion:</h3> SJD symptoms are partly explained by neurocognitive manifestations in patients with SJD. Out of the neurocognitive tests performed, DSST may be best in assessing physical and mental fatigue. DSST is commonly used in assessing cognitive function in other patients, and this result suggests that it may add value to the assessment of fatigue in patients with SJD. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This work is funded by the NIHR Newcastle Biomedical Research Centre. <h3>Disclosure of Interests:</h3> <b>None declared.</b>