title: Cognitive impairment in Brazilian patients with Behçet's disease occurs independently of neurologic manifestation.
abstract: Neuro-Behçet's disease (NBD) presents cognitive and behavioral symptoms possibly explained by secondary dysfunction of frontal and temporal cortices due to subcortical damage, as NBD commonly involves the brainstem and basal ganglia. Nonetheless, there are reports of cognitive impairment in patients without neurological manifestations.
  
  
  OBJECTIVE
  To evaluate cognitive function in Behçet's disease (BD) patients with and without neurological manifestations and to analyze clinical variables associated with cognitive deficits.
  
  
  METHODS
  This is a cross-sectional study that compared healthy controls, BD patients without neurological manifestations and NBD patients. Each group comprised 24 participants. All participants underwent neuropsychological evaluation, Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory (BDI) application and brain MRI. Cumulative prednisone dose, years of education, and presence of white-matter lesions in brain MRI were recorded.
  
  
  RESULTS
  41.6% of BD and 41.6% of NBD patients showed impaired language and executive function, whereas visual memory was impaired only in NBD patients. Multiple logistic regression revealed that anxiety (OR 1.09 95% CI 1.03-1.16, p=0.003) and lower educational level (OR 0.62 95% CI 0.48-0.80, p<0.0001) were independently associated with cognitive impairment.
  
  
  CONCLUSIONS
  Cognitive impairment occurs frequently in patients with BD independently of neurological manifestation. Low educational level and anxiety are risk factors for cognitive impairment in BD.
authors: Department of Neurology and Neurosurgery, Division of General Neurology, Universidade Federal de São Paulo, Brazil. liviaadutra@hotmail.com
authors: Lívia Almeida
authors: LA
authors: Dutra
authors: Alexandre Wagner Silva
authors: AW
authors: de Souza
authors: Helena
authors: H
authors: Alessi
authors: Bruno de Vasconcelos Sobreira
authors: Bde V
authors: Guedes
authors: Pedro
authors: P
authors: Braga-Neto
authors: José Luiz
authors: JL
authors: Pedroso
authors: Celio Roberto
authors: CR
authors: Gonçalves
authors: Antonio José
authors: AJ
authors: da Rocha
authors: Paulo Henrique Ferreira
authors: PH
authors: Bertolucci
authors: Orlando Graziani Povoas
authors: OG
authors: Barsottini
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D001938:Brazil / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D009483:Neuropsychological Tests; D012307:Risk Factors