TY  - JOUR
A1  - Yalachkov, Yavor Vasilev
A1  - Uhlmann, Valerie
A1  - Bergmann, Johannes
A1  - Soydaş, Dilara
A1  - Frisch, Stefan
A1  - Behrens, Marion
A1  - Förch, Christian
A1  - Gehrig, Johannes
T1  - Patients with chronic autoimmune demyelinating polyneuropathies exhibit cognitive deficits which might be associated with CSF evidence of blood-brain barrier disturbance
T2  - PLoS one
N2  - Background: Chronic autoimmune demyelinating polyneuropathies (CADP) result in impaired sensorimotor function. However, anecdotal clinical observations suggest the development of cognitive deficits during the course of disease.
Methods: We tested 16 patients with CADP (11 patients with chronic inflammatory demyelinating polyneuropathy, 4 patients with multifocal motor neuropathy and 1 patient with multifocal acquired demyelinating sensory and motor neuropathy) and 40 healthy controls (HC) with a neuropsychological test battery. Blood-brain-barrier dysfunction (BBBd) in patients was assessed retrospectively by analysing the cerebral spinal fluid (CSF) status at the time the diagnosis of CAPD was established.
Results: CADP patients failed on average in 1.7 out of 9 neuropsychological tests (SD ± 1.25, min. 0, max. 5). 50% of the CADP patients failed in at least two neuropsychological tests and 44.3% of the patients failed in at least two different cognitive domains. CADP patients exhibiting BBBd at the time of first diagnosis failed in more neuropsychological tests than patients with intact integrity of the BBB (p < 0.05). When compared directly with the HC group, CADP patients performed worse than HC in tests measuring information processing ability and speed as well as phonemic verbal fluency after adjusting for confounding covariates.
Conclusions: Our results suggest that mild to moderate cognitive deficits might be present in patients with CAPD. One possible tentative explanation, albeit strong evidence is still lacking for this pathophysiological mechanism, refers to the effect of autoimmune antibodies entering the CNS via the dysfunctional blood-brain barrier typically seen in some of the CADP patients.
KW  - Cognitive impairment
KW  - Neuropsychological testing
KW  - Cognitive neurology
KW  - Magnetic resonance imaging
KW  - Central nervous system
KW  - Cerebrospinal fluid
KW  - Neuropsychology
KW  - Neuropathic pain
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/52889
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-528892
SN  - 1932-6203
N1  - Copyright: © 2020 Yalachkov et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 15
IS  - (2): e0228679
SP  - 1
EP  - 15
PB  - PLoS
CY  - Lawrence, Kan.
ER  -