INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #18 Neuropsychological Functioning in Sarcoidosis Urja Bhatia, Kent State University, Kent, United States Kaltra Dhima, Vanderbilt University Medical Center, Nashville, United States Eileen Yu, Case Western Reserve University, Cleveland, United States Tasha Rhoads, Cleveland Clinic, Cleveland, United States Jeffrey Lambe, Cleveland Clinic, Cleveland, United States Brandon Moss, Cleveland Clinic, Cleveland, United States Amy Kunchok, Cleveland Clinic, Cleveland, United States Rachel Galioto, Cleveland Clinic, Cleveland, United States Category: Medical/Neurological Disorders/Other (Adult) Keyword 1: cognitive functioning Objective: Sarcoidosis is a multisystem inflammatory disease that most commonly affects the lungs. Neurological involvement is thought to occur in 5-10% of patients with sarcoidosis, but recent research demonstrates that one-third endorse subjective cognitive dysfunction. To date, no studies have comprehensively assessed cognitive functioning in this population. The current study is the first to objectively examine neuropsychological function across all cognitive domains in patients with sarcoidosis. We aimed to: (1) report the prevalence of cognitive impairment and mood symptoms in patients with sarcoidosis; (2) compare neuropsychological profiles of patients with and without neurologic involvement; and (3) examine differences in mood and sample characteristics between cognitively impaired and intact patients. Participants and Methods: We retrospectively identified 46 patients (67.4% female, 51.6 ± 9.6 years old, 14.3 ± 2.3 years of education) diagnosed with sarcoidosis who completed a clinical neuropsychological evaluation and did not have comorbid neurological conditions or severe mental illness. There was some variability in tests administered given the clinical nature of the evaluations. Mood was assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory – II (BDI-II). Rates of impairment on neuropsychological testing were examined for the full sample. Independent samples t-tests were used to examine differences on neuropsychological test performance between patients with and without probable or definite neurological involvement (i.e., neurosarcoidosis). Cognitively impaired and intact patients were compared on mood measures and sample characteristics using independent samples t-tests or chi-square tests. Results: Approximately half (52.2%) of the sample was classified as cognitively impaired. Neurosarcoidosis was found in 37% of the sample. Of the 43 patients with available brain MRI data, 55.8% displayed abnormal brain parenchymal disease. At least one cerebrovascular risk factor was present in 61% of the sample. Twenty percent of the sample was on at least one psychotropic medication at the time of evaluation. Rates of impairment in the full sample were most notable on measures of word-list verbal memory (21.7% learning, 28.3% delayed recall, 13.3% recognition), visual memory (40% learning, 28% delayed recall, 20% recognition), verbal fluency (26.1-28.2%), confrontation naming (17.8%), and executive functioning (up to 30.6%). Moderate to severe levels of anxiety were reported by 39.5% of the sample, and 27.9% reported moderate to severe levels of depression. Patients with neurosarcoidosis displayed significantly poorer immediate story memory [t(38)=2.1, p=.044] and visual scanning/sequencing [t(43)=2.4, p=.023] compared to patients without neurosarcoidosis. Cognitively impaired patients reported greater levels of depression compared to cognitively intact patients [t(31)=-2.8, p=.009]. Conclusions: The current study’s findings suggest that cognitive impairment may be more common than is recognized among patients with sarcoidosis. The overall sample showed deficits in memory, language, and executive functioning, yet patients with neurosarcoidosis showed greater difficulty with story learning and visual scanning/sequencing relative to patients with sarcoidosis alone. Additional research with larger samples is needed to better understand the rates and patterns of cognitive deficits in sarcoidosis, as well as the potential physiological underpinnings. This could lead to earlier detection of cognitive impairment and development of novel interventions.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #18

Neuropsychological Functioning in Sarcoidosis

Urja Bhatia, Kent State University, Kent, United States
Kaltra Dhima, Vanderbilt University Medical Center, Nashville, United States
Eileen Yu, Case Western Reserve University, Cleveland, United States
Tasha Rhoads, Cleveland Clinic, Cleveland, United States
Jeffrey Lambe, Cleveland Clinic, Cleveland, United States
Brandon Moss, Cleveland Clinic, Cleveland, United States
Amy Kunchok, Cleveland Clinic, Cleveland, United States
Rachel Galioto, Cleveland Clinic, Cleveland, United States

Category: Medical/Neurological Disorders/Other (Adult)

Keyword 1: cognitive functioning

Objective:

Sarcoidosis is a multisystem inflammatory disease that most commonly affects the lungs. Neurological involvement is thought to occur in 5-10% of patients with sarcoidosis, but recent research demonstrates that one-third endorse subjective cognitive dysfunction. To date, no studies have comprehensively assessed cognitive functioning in this population. The current study is the first to objectively examine neuropsychological function across all cognitive domains in patients with sarcoidosis. We aimed to: (1) report the prevalence of cognitive impairment and mood symptoms in patients with sarcoidosis; (2) compare neuropsychological profiles of patients with and without neurologic involvement; and (3) examine differences in mood and sample characteristics between cognitively impaired and intact patients.

Participants and Methods:

We retrospectively identified 46 patients (67.4% female, 51.6 ± 9.6 years old, 14.3 ± 2.3 years of education) diagnosed with sarcoidosis who completed a clinical neuropsychological evaluation and did not have comorbid neurological conditions or severe mental illness. There was some variability in tests administered given the clinical nature of the evaluations. Mood was assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory – II (BDI-II). Rates of impairment on neuropsychological testing were examined for the full sample. Independent samples t-tests were used to examine differences on neuropsychological test performance between patients with and without probable or definite neurological involvement (i.e., neurosarcoidosis). Cognitively impaired and intact patients were compared on mood measures and sample characteristics using independent samples t-tests or chi-square tests.

Results:

Approximately half (52.2%) of the sample was classified as cognitively impaired. Neurosarcoidosis was found in 37% of the sample. Of the 43 patients with available brain MRI data, 55.8% displayed abnormal brain parenchymal disease. At least one cerebrovascular risk factor was present in 61% of the sample. Twenty percent of the sample was on at least one psychotropic medication at the time of evaluation. Rates of impairment in the full sample were most notable on measures of word-list verbal memory (21.7% learning, 28.3% delayed recall, 13.3% recognition), visual memory (40% learning, 28% delayed recall, 20% recognition), verbal fluency (26.1-28.2%), confrontation naming (17.8%), and executive functioning (up to 30.6%). Moderate to severe levels of anxiety were reported by 39.5% of the sample, and 27.9% reported moderate to severe levels of depression. Patients with neurosarcoidosis displayed significantly poorer immediate story memory [t(38)=2.1, p=.044] and visual scanning/sequencing [t(43)=2.4, p=.023] compared to patients without neurosarcoidosis. Cognitively impaired patients reported greater levels of depression compared to cognitively intact patients [t(31)=-2.8, p=.009].

Conclusions:

The current study’s findings suggest that cognitive impairment may be more common than is recognized among patients with sarcoidosis. The overall sample showed deficits in memory, language, and executive functioning, yet patients with neurosarcoidosis showed greater difficulty with story learning and visual scanning/sequencing relative to patients with sarcoidosis alone. Additional research with larger samples is needed to better understand the rates and patterns of cognitive deficits in sarcoidosis, as well as the potential physiological underpinnings. This could lead to earlier detection of cognitive impairment and development of novel interventions.