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Zeng P, Zhao B, Li M, Wang Y, Cai G, Chen R, Chen L, Liu J. The volumes of amygdala subregions and peripheral programmed cell death protein-1 levels are associated with cognitive decline in individuals with knee osteoarthritis. Brain Behav 2024; 14:e70042. [PMID: 39344268 DOI: 10.1002/brb3.70042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 05/30/2024] [Accepted: 08/21/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Persistent pain is a prominent symptom of knee osteoarthritis (KOA) and has been associated with cognitive decline in individuals with KOA. The amygdala, a complex structure consisting of nine subnuclei, and programmed cell death protein-1 (PD-1) levels play crucial roles in pain regulation and cognitive processing. This study aims to investigate the relationships among amygdala subregion volumes, cognitive function, and PD-1 levels to elucidate the underlying mechanism of cognitive decline in KOA. METHODS In this cross-sectional study, we recruited 36 patients with KOA and 25 age/gender-matched healthy controls for neuropsychological tests, structural magnetic resonance imaging scanning, and measurement of serum PD-1 levels. We used the atlas provided by FreeSurfer software to automatically segment the amygdala subnuclei. Subsequently, we compared the volumes of amygdala subregions between groups and explored their correlation with clinical scores and PD-1 levels. RESULTS Compared to healthy controls, individuals with KOA exhibited significantly lower scores on global cognition tasks, such as long-delay free recall, short-delay free recall, and immediate recall tasks. Moreover, they displayed decreased volumes in lateral nucleus basal nucleus paralaminar nucleus while showing increased volumes in accessory basal nucleus, central nucleus, medial nucleus, and cortical nucleus. Within the KOA group specifically, paralaminar volume was negatively correlated with immediate recall scores; pain scores were negatively correlated with global cognition; basal volume was negatively correlated with PD-1 levels. CONCLUSION Our findings highlight those alterations in amygdala subregion volumes along with changes in serum PD-1 levels may contribute to observe cognitive decline among individuals suffering from KOA.
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Affiliation(s)
- Peiling Zeng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Baoru Zhao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ming Li
- Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yajun Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Guiyan Cai
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ruilin Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, Fuzhou, Fujian, China
| | - Jiao Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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Lv T, Yu H, Ji Z, Ma L. The association between arthritis and cognitive function impairment in the older adults: Based on the NHANES 2011-2014. PLoS One 2024; 19:e0310546. [PMID: 39331629 PMCID: PMC11432873 DOI: 10.1371/journal.pone.0310546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/02/2024] [Indexed: 09/29/2024] Open
Abstract
OBJECTIVE Arthritis has been postulated as a prevalent potential risk factor for the emergence of dementia and cognitive impairment. This conjecture prompted an examination of the correlation between arthritis and cognitive impairment using the National Health and Nutrition Examination Survey (NHANES) repository. The analysis was meticulously adjusted for potential confounders such as age and assorted systemic comorbidities, to ensure robustness in the results obtained. METHODS Among 2,398 adults aged 60 years and above, logistic regression and cubic spline models were employed to elucidate the relationship between arthritis and cognitive performance. This was assessed utilizing tests such as Immediate Recall test (IRT), Delayed Recall test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). RESULTS In our investigation, a total of 19931 individuals were analyzed, among which 2,398 patients (12.03%) were identified with arthritis. Subjects with arthritis inflammation had lower DSST and AFT scores compared to the healthy group, indicating cognitive decline. After adjusting for all covariates, arthritis was significantly associated with higher DSST and AFT scores by logistic regression modeling (OR: 0.796, 95% CI: 0.649-0.975; OR: 0.769, 95% CI: 0.611-0.968). CONCLUSION Our analysis underscores the potential linkage between arthritis prevalence and cognitive impairment within a nationally representative of US older adults.
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Affiliation(s)
- Taihong Lv
- Department of General Practice, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Hanming Yu
- Department of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Zishuo Ji
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Li Ma
- Department of General Practice, Beijing TianTan Hospital, Capital Medical University, Beijing, China
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Gazik AB, Vagharseyyedin SA, Saremi Z, Shafiee F. Severity of Pain Catastrophizing and Its Associations With Cognitive Flexibility and Self-Efficacy in Patients With Rheumatoid Arthritis. Musculoskeletal Care 2024; 22:e1923. [PMID: 39095941 DOI: 10.1002/msc.1923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 07/14/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Pain catastrophizing in patients with rheumatoid arthritis exacerbates negative pain-related outcomes, such as anxiety, depression, and pain intensity. Therefore, it is essential to investigate the severity of pain catastrophizing and the factors contributing to it among these patients. The present study aimed to assess the severity of pain catastrophizing and its association with cognitive flexibility and self-efficacy in a sample of Iranian patients with rheumatoid arthritis. METHODS A descriptive correlational study was conducted on 220 rheumatoid patients referred to a rheumatology clinic affiliated with Birjand University of Medical Sciences, Birjand, Iran. The instruments used to collect data included a demographic form, the Pain Catastrophizing Scale, the Cognitive Flexibility Inventory, and the Arthritis Self-Efficacy Scale. The data were analysed using SPSS version 24. RESULTS The mean age of the participants was 53.25 ± 12.41 years, and the mean duration of their disease was 6.63 ± 3.39 years. The majority of participants, specifically 61.8%, reported high levels of pain catastrophizing. An inverse and significant correlation was found between pain catastrophizing and cognitive flexibility (p < 0.001). Likewise, pain catastrophizing exhibited an inverse and significant correlation with self-efficacy and all its dimensions (p < 0.001). The results of the multiple linear regression analysis indicate that the final significant predictors of pain catastrophizing were cognitive flexibility (β = -0.34, p < 0.001) and self-efficacy (β = -0.53, p < 0.001). These predictors were found to significantly explain 51% of the variance in catastrophizing. CONCLUSIONS Through psychosocial interventions aimed at enhancing pain self-efficacy and cognitive flexibility, healthcare providers can hope to reduce pain catastrophizing and its adverse effects in patients with rheumatoid arthritis.
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Affiliation(s)
- Ahmad Bavali Gazik
- Student Research and Technology Committee, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Zeinab Saremi
- Department of Internal Medicine, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Shafiee
- Faculty of Nursing and Midwifery, Department of Nursing, Birjand University of Medical Sciences, Birjand, Iran
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Baek W, Suh Y, Ji Y. Impact of frailty severity and severe pain on cognitive function for community-dwelling older adults with arthritis: a cross-sectional study in Korea. Sci Rep 2024; 14:2874. [PMID: 38311657 PMCID: PMC10838920 DOI: 10.1038/s41598-024-53431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
Pain is a major symptom of arthritis in older adults, often leading to frailty and cognitive decline. However, few studies have investigated the relationship among pain, frailty, and cognitive function in older adults with arthritis. This study aimed to investigate the factors influencing cognitive function and the impact of frailty severity and pain on cognitive function in older adults with arthritis using a Korean population-based dataset. This cross-sectional descriptive study involved the secondary data of 1089 participants from the seventh and eighth waves of the Korean Longitudinal Study on Aging. We examined general characteristics, health behaviors, health conditions (including severe pain and frailty), and cognitive function. Participants were categorized based on the presence or absence of pain severity and frailty status as follows: robust, only severe pain, only prefrail, prefrail with severe pain, only frail, and frail with severe pain. Multiple linear regression analysis was performed to establish correlations between groups and cognitive function. The only-prefrail group was the largest (19.7%) among participants experiencing either pain or frailty. Advanced age, sex, level of education, and visual and hearing impairments were significantly associated with cognitive function. Compared to the robust group, only prefrail (β = -1.54, confidence interval [CI] = - 2.33; - 0.76), prefrail with severe pain (β = - 2.69, CI = - 3.52; - 1.87), only frail (β = - 4.02, CI = - 5.08; - 2.97), and frail with severe pain (β = - 5.03, CI = - 5.99; - 4.08) groups were associated with lower Mini-Mental State Examination scores. The study confirmed that severe pain alone does not significantly impact cognitive function in older adults with arthritis. To prevent cognitive decline in this group, assessment of both pain and frailty severity is essential to predict high-risk groups and provide appropriate interventions, such as transfer to hospitals or primary clinics according to the severity of pain and frailty.
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Affiliation(s)
- Wonhee Baek
- College of Nursing, Gyeongsang National University, Jinju, Gyeongnam, South Korea
| | - Yujin Suh
- Healthcare Sciences and the Human Ecology Research Institute, Department of Nursing, Healthcare Sciences and the Human Ecology, Dong-eui University, Busan, South Korea
| | - Yoonjung Ji
- Brain Korea 21 FOUR Project, Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Tong B, Chen H, Wang M, Liu P, Wang C, Zeng W, Li D, Shang S. Association of body composition and physical activity with pain and function in knee osteoarthritis patients: a cross-sectional study. BMJ Open 2024; 14:e076043. [PMID: 38233052 PMCID: PMC10806729 DOI: 10.1136/bmjopen-2023-076043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE The objective of this study is to delineate disparities between patients with knee osteoarthritis (KOA) based on obesity status, investigate the interplay among body composition, physical activity and knee pain/function in patients with KOA and conduct subgroup analyses focusing on those with KOA and obesity. DESIGN Cross-sectional study. SETTING Residents of eight communities in Shijiazhuang, Hebei Province, China, were surveyed from March 2021 to November 2021. PARTICIPANTS 178 patients with symptomatic KOA aged 40 years or older were included. MAIN OUTCOMES AND MEASURES The primary outcome measure was knee pain, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index-pain (WOMAC-P) scale. Secondary outcome measures included function, evaluated through the WOMAC-function (WOMAC-F) scale and the Five-Time-Sit-to-Stand Test (FTSST). Data analysis involved t-tests, Wilcoxon rank-sum tests, χ2 tests, linear and logistical regression analysis. RESULTS Participants (n=178) were 41-80 years of age (median: 65, P25-P75: 58-70), and 82% were female. Obese patients (n=103) had worse knee pain and self-reported function (p<0.05). In general patients with KOA, body fat mass was positively associated with bilateral knee pain (β=1.21 (95% CI 0.03 to 0.15)), WOMAC-P scores (β=0.25 (95% CI 0.23 to 1.22)), WOMAC-F scores (β=0.28 (95% CI 0.35 to 1.29)) and FTSST (β=0.19 (95% CI 0.03 to 0.42)), moderate-intensity to low-intensity physical activity was negatively associated with bilateral knee pain (β=-0.80 (95% CI -0.10 to -0.01)) and Skeletal Muscle Index (SMI) was negatively associated with WOMAC-F scores (β=-0.16 (95% CI -0.66 to -0.03)). In patients with KOA and obesity, SMI was negatively associated with FTSST (β=-0.30 (95% CI -3.94 to -0.00)). CONCLUSION Patients with KOA and obesity had worse knee pain and self-reported function compared with non-obese patients. Greater fat mass, lower muscle mass and lower moderate-intensity to low-intensity physical activity were associated with increased knee pain and poor self-reported function. More skeletal muscle mass was associated with the improvement of objective function.
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Affiliation(s)
- Beibei Tong
- Peking University School of Nursing, Peking University, Beijing, China
| | - Hongbo Chen
- Nursing Department of Peking University Third Hospital, Peking University Third Hospital, Beijing, China
| | - Mengqi Wang
- Peking University School of Nursing, Peking University, Beijing, China
| | - Peiyuan Liu
- Peking University School of Nursing, Peking University, Beijing, China
| | - Cui Wang
- Peking University School of Nursing, Peking University, Beijing, China
| | - Wen Zeng
- Peking University School of Nursing, Peking University, Beijing, China
| | - Dan Li
- Peking University School of Nursing, Peking University, Beijing, China
| | - Shaomei Shang
- Peking University School of Nursing, Peking University, Beijing, China
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Antoine LH, Tanner JJ, Mickle AM, Gonzalez CE, Kusko DA, Watts KA, Rumble DD, Buchanan TL, Sims AM, Staud R, Lai S, Deshpande H, Phillips B, Buford TW, Aroke EN, Redden DT, Fillingim RB, Goodin BR, Sibille KT. Greater socioenvironmental risk factors and higher chronic pain stage are associated with thinner bilateral temporal lobes. Brain Behav 2023; 13:e3330. [PMID: 37984835 PMCID: PMC10726852 DOI: 10.1002/brb3.3330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Previous research indicates ethnic/race group differences in pain and neurodegenerative diseases. Accounting for socioenvironmental factors reduces ethnic/race group differences in clinical and experimental pain. In the current study sample, we previously reported that in individuals with knee pain, ethnic/race group differences were observed in bilateral temporal lobe thickness, areas of the brain associated with risk for Alzheimer's disease, and related dementias. The purpose of the study was to determine if socioenvironmental factors reduce or account for previously observed ethnic/race group differences and explore if a combined effect of socioenvironmental risk and chronic pain severity on temporal lobe cortices is evident. METHODS Consistent with the prior study, the sample was comprised of 147 adults (95 women, 52 men), 45-85 years of age, who self-identified as non-Hispanic Black (n = 72) and non-Hispanic White (n = 75), with knee pain with/at risk for osteoarthritis. Measures included demographics, health history, pain questionnaires, cognitive screening, body mass index, individual- and community-level socioenvironmental factors (education, income, household size, marital and insurance status, and area deprivation index), and brain imaging. We computed a summative socioenvironmental risk index. RESULTS Regression analyses showed that with the inclusion of socioenvironmental factors, the model was significant (p < .001), and sociodemographic (ethnic/race) group differences were not significant (p = .118). Additionally, findings revealed an additive stress load pattern indicating thinner temporal lobe cortices with greater socioenvironmental risk and chronic pain severity (p = .048). IMPLICATIONS Although individual socioenvironmental factors were not independent predictors, when collectively combined in models, ethnic/race group differences in bilateral temporal lobe structures were not replicated. Further, combined socioenvironmental risk factors and higher chronic pain severity were associated with thinner bilateral temporal lobes.
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Affiliation(s)
- Lisa H. Antoine
- Department of PsychologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jared J. Tanner
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Angela M. Mickle
- Pain Research & Intervention Center of ExcellenceUniversity of FloridaGainesvilleFloridaUSA
- Department of Physical Medicine & RehabilitationUniversity of FloridaGainesvilleFloridaUSA
| | - Cesar E. Gonzalez
- Department of PsychologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Daniel A. Kusko
- Department of PsychologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Kristen Allen Watts
- Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Deanna D. Rumble
- Department of Psychology and CounselingUniversity of Central ArkansasConwayArkansasUSA
| | - Taylor L. Buchanan
- Center for Exercise MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Andrew M. Sims
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Roland Staud
- Department of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Song Lai
- Department of Radiation OncologyUniversity of FloridaGainesvilleFloridaUSA
| | | | - Brandis Phillips
- Department of Accounting & FinanceNorth Carolina A&T State UniversityGreensboroNorth CarolinaUSA
| | - Thomas W. Buford
- Department of Medicine − Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Birmingham/Atlanta Geriatric Research, Education, and Clinical CenterBirmingham VA Medical CenterBirminghamAlabamaUSA
| | - Edwin N. Aroke
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - David T. Redden
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Roger B. Fillingim
- Pain Research & Intervention Center of ExcellenceUniversity of FloridaGainesvilleFloridaUSA
- Department of Community of Dentistry and Behavioral SciencesUniversity of FloridaGainesvilleFloridaUSA
| | - Burel R. Goodin
- Department of PsychologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of AnesthesiologyWashington University, Washington University Pain CenterSt. LouisMissouriUSA
| | - Kimberly T. Sibille
- Pain Research & Intervention Center of ExcellenceUniversity of FloridaGainesvilleFloridaUSA
- Department of Physical Medicine & RehabilitationUniversity of FloridaGainesvilleFloridaUSA
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