Central nervous system involvement in Sjogren's syndrome: evidence from neuropsychological testing and HMPAO-SPECT

Objective, -To investigate the clinical, neuropsychological and imaging man ifestations of Sjogren's syndrome (SS), a chronic auto-immune disease with peripheral and central nervous system (CNS) involvement, Design/Methods, -Fourteen female patients suffering from confirmed SS under went within 2 weeks: neurological examination, immunological staging, brain MRI, brain 99m Tc-HMPAO SPECT, psychological evaluation and in-depth neuro psychological testing, Results, - All patients showed neuropsychological abnormalities. The cognit ive symptoms were of the same type in all patients, mostly frontal lobe syn drome and memory problems. The neuropsychological involvement was not assoc iated with other kinds of CNS involvement or MRT abnormalities, but accurat ely reflected HMPAO imaging results. Conclusions. - The results of this study indicate that cognitive evaluation is the most sensitive clinical test to diagnose CNS involvement in patient s with SS, and that CNS involvement in SS seems to be more frequent when sy stematically assessed by neuropsychological tests.