Cognitive Functioning in Egyptian Behçet\'s disease patients: clinical, psychiatric, and Brain MRI evaluation

Objectives: Investigation of the cognitive profile of the Egyptian behcet disease (BD) patients in comparison to healthy subjects. Introduction: Neurological involvement of BD either in the form focal parenchymal involvement or cerebral venous sinus thrombosis. The impact of BD on cognitive functions is still poorly understood. Materials and methods: Forty BD patients were included in this study (20 of them had history of neurological involvement (Neuro-BD) and the other 20 patients had no current or past neurological manifestations). All were recruited from Zagazig University Hospitals- Egypt. Twenty healthy subjects, with no history of neurological or psychiatric disorders were taken as a control group. Disease activity assessed by Behçet's Disease Current Activity Form (BDCAF). Cognitive functions assessed by: Montreal Cognitive Assessment (MoCA) and Trail Making Test (TMT) (part A and B). Hospital Anxiety and Depression Scale (HADS) was used to assess severity of depression and anxiety. Brain MRI imaging for patients was analyzed by the age-related white matter changes (ARWMC) scale. Results: All tests of cognition (MoCA, TMT-A and TMT-B) were impaired in both Neuro-BD and BD patients, compared to healthy subjects (p= 0.00). MRI scans showed positive findings in; frontal lobes, parieto-occipital region, and basal ganglia. Patients with white matter changes on the frontal lobes had poorer performance on the (MoCA, TMT- A and TMT- B tests) than those without (p= 0.03, 0.00, 0.00 respectively). Conclusion: Silent neurological BD patients represented 20% of Egyptian BD patients. Periodic psychometric testing along with brain MRI is recommended.