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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2024.tde-13052024-153409
Document
Author
Full name
Jéssica Sainça Rodrigues
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2023
Supervisor
Committee
Marques, Vanessa Daccach (President)
Rodrigues, Maria Carolina de Oliveira
Damasceno, Alfredo
Title in Portuguese
Avaliação de transtorno cognitivo em paciente com doença de Sjögren na população brasileira: estudo epidemiológico na cidade de Ribeirão Preto
Keywords in Portuguese
Doença de Sjögren
Síndrome de Sjögren primária
Transtorno cognitivo
Abstract in Portuguese
Introdução: A doença de Sjögren (DSj) é uma das doenças reumatológicas inflamatórias autoimunes mais comuns. Um terço dos pacientes pode apresentar envolvimento extraglandular, sendo que a manifestação de sintomas neurológicos consiste em uma das mais frequentes. Pode-se dividir as manifestações neurológicas da DSj em acometimento periférico e de sistema nervoso central (SNC). Dentre os sintomas do SNC, a queixa de disfunção cognitiva possui alta prevalência. Objetivos: Compreender se há de fato acometimento cognitivo nesta população e propor uma bateria de testes de avaliação para uso na prática clínica. Métodos: Estudo prospectivo, observacional, incluindo paciente com DSj que preenchem os critérios de classificação ACR-EULAR 2016, e frequentam o ambulatório de colagenoses do Hospital das Clínicas de Ribeirão Preto-SP, com idade entre 18 e 65 anos. Estes pacientes foram submetidos a aplicação de uma bateria de testes de avaliação cognitiva e métricas de atividade de doença (EULAR Sjögren's Syndrome Disease Activity Index - ESSDAI). Outro grupo (controle), composto de acompanhantes dos pacientes durante a consulta médica no ambulatório de colagenoses, também foi submetido a mesma bateria de teste cognitivo. Resultados: Setenta e cinco pacientes com DSj participaram deste estudo com 30 controles. Os grupos foram ajustados para as variáveis sexo e escolaridade. O MoCA mostrou-se alterado em 77,3% dos pacientes, além das fases de Cópia e Codificação com esforço no teste de 3P3F indicando disfunção subcortical cognitiva, semelhante aos dados encontrados na literatura. Conclusão: Os dados obtidos comprovam a necessidade de inclusão da avaliação cognitiva como parte obrigatória do exame clínico nestes pacientes, mesmo na ausência de queixas.
Title in English
Assessment of cognitive disorders in patients with Sjögren's disease in the Brazilian population: epidemiological study in the city of Ribeirão Preto
Keywords in English
Cognitive disorder
Primary Sjögren's syndrome
Sjögren's disease
Abstract in English
Backgrounds: Sjögren's disease (SjD) is one of the most common autoimmune inflammatory rheumatological diseases. One third of patients may present extraglandular involvement, with the manifestation of neurological symptoms being one of the most frequent. The neurological manifestations of SjD can be divided into peripheral and central nervous system (CNS) involvement. Among CNS symptoms, the complaint of cognitive dysfunction has a high prevalence. Objectives: To understand whether there is indeed cognitive impairment in this population and to propose a battery of assessment tests for use in clinical practice. Methods: Prospective, observational study, including patients with SjD who meet the ACR-EULAR 2016 classification criteria, and attend the collagenosis outpatient clinic at Hospital das Clínicas de Ribeirão Preto-SP, aged between 18 and 65 years. These patients were subjected to a battery of cognitive assessment tests and disease activity metrics (EULAR Sjögren's Syndrome Disease Activity Index - ESSDAI). Another group (control), composed by patients' companions during the medical consultation at the collagenosis outpatient clinic, was also subjected to the same cognitive test battery. Results: Seventy-five patients with SjD participated in this study with 30 controls. The groups were adjusted for the variables gender and education. MoCA was found to be altered in 77.3% of patients, in addition to the Copy and Coding phases with effort in the 3W3S test, indicating cognitive subcortical dysfunction, similar to the data found in the literature. Conclusion: The data obtained prove the need to include cognitive assessment as a mandatory part of the clinical examination in these patients, even in the absence of complaints.
 
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Publishing Date
2024-07-17
 
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