Crohn’s Disease with Cognitive Impairments Linked to Systemic Inflammation, Poor Sleep Quality

Crohn’s Disease with Cognitive Impairments Linked to Systemic Inflammation, Poor Sleep Quality

Patients with Crohn’s disease often have subtle cognitive impairment with slower response times compared to people without the disease, according to a recent study developed at the Monash University and Department of Gastroenterology and Hepatology in Australia.

The study, “Cognitive impairment in Crohn’s disease is associated with systemic inflammation, symptom burden and sleep disturbance,” published in the United European Gastroenterology Journal, shows that cognitive difficulties in Crohn’s disease patients are strongly associated with increased systemic inflammation, and might be caused by indirect disease effects such as disease duration, anxiety, and sleep disturbances.

Patients with Crohn’s disease, one of the two main forms of inflammatory bowel disease (IBD), have a variety of effects on health and normal function beyond classic symptoms, like abdominal pain and diarrhea. These patients frequently complain of difficulty in concentrating and though cloudiness, but these symptoms are often ignored by clinicians.

Identifying decrements in cognitive function, even subtle ones, is important as they may lead to increased risk of car or workplace accidents. But few studies have reported changes in cognitive function in patients with chronic diseases like Crohn’s.

The research team here sought to compare the cognitive function in Crohn’s patients and identify specific disease- and patient-related factors that could be associated with a decrease in cognitive function. They enrolled 41 patients with Crohn’s and 31 healthy people, who were assessed using the Subtle Cognitive Impairment Test (SCIT), a sensitive test that detects mild cognitive impairment.

Results revealed that patients with Crohn’s disease had response times that were 10 percent slower than normal controls; in fact, their response time was even slower than those observed in healthy volunteers who presented blood alcohol limits above 0.05 g/100 mL, which is over the legal drink drive limit in most countries of the European Union.

“These results reinforce the notion that Crohn’s has a wide range of multi-systemic consequences with the impact of the disease affecting patients not only within but well beyond the digestive tract,” Daniel van Langenberg, the lead researcher of the study, said in a press release.

The researchers also found that increased response times significantly correlated with measures of systemic inflammation, but inversely correlated with intestinal mucosal inflammation.

“The findings appear consistent with experiments that have shown that bowel inflammation results in an upregulation of inflammatory hippocampus activity in the brain. This, in turn, might account for the slower response times that were observed in the study,” van Langenberg said.

In addition, the team found that certain indirect effects of the disease, including poor sleep quality, anxiety, symptom burdens, and disease duration were also associated with increased cognitive impairment.

“This research highlights the need for regular interventions with multi-disciplinary IBD teams to address the wide issues that are presented with Crohn’s disease. This will enable a greater understanding of this complex condition and therefore improve the service and care offered to each patient,” said Prof. Gigi Veereman, an IBD expert from the United European Gastroenterology Journal.

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