Jonathan I Silverberg1, Donald Lei2, Muhammad Yousaf2, Sherief R Janmohamed2, Paras P Vakharia3, Rishi Chopra4, Rajeev Chavda5, Sylvie Gabriel5, Kevin R Patel6, Vivek Singam7, Robert Kantor4, Derek Y Hsu2, David Cella8. 1. Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC; Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois. Electronic address: jonathanisilverberg@gmail.com. 2. Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois. 3. Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas. 4. Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York. 5. Galderma SA, Rx Strategy & Innovation Group, La Tour-de-Peliz, Switzerland. 6. Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts. 7. Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois. 8. Departments of Medical Social Sciences, Preventive Medicine, Neurology, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Abstract
BACKGROUND: Atopic dermatitis (AD) is associated with itch, pain, and sleep disturbance, all of which may contribute toward cognitive dysfunction. OBJECTIVE: To determine the relationship of AD severity and cognitive function in adults. METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 386). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. RESULTS: At baseline, 118 patients (58.1%) reported ≥1 symptoms of cognitive dysfunction in the past 4 weeks, with 29 (14.3%) having mild, 11 (5.4%) moderate, and 4 (2.0%) severe PROMIS Cognitive Function T-scores. In propensity score-weighted regression models, PROMIS Cognitive Function T-scores were inversely associated with patient-reported global AD severity, Patient Oriented Eczema Measure (POEM), Numeric Rating Scale worst itch and skin pain, SCORing Atopic Dermatitis (SCORAD)-sleep, POEM-sleep, Eczema Area and Severity Index, and SCORAD, with stepwise decreases of cognitive function with worsening AD severity. At all AD severity levels, cognitive dysfunction was associated with increased Dermatology Life Quality Index and ItchyQoL scores. Changes from baseline in PROMIS Cognitive Function T-scores were weakly to moderately inversely correlated with changes from baseline in multiple AD outcomes. LIMITATIONS: Single-center study without non-AD controls. CONCLUSION: Cognitive dysfunction is associated with AD severity. Cognitive function may be an important end point for monitoring treatment response in AD.
BACKGROUND:Atopic dermatitis (AD) is associated with itch, pain, and sleep disturbance, all of which may contribute toward cognitive dysfunction. OBJECTIVE: To determine the relationship of AD severity and cognitive function in adults. METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 386). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. RESULTS: At baseline, 118 patients (58.1%) reported ≥1 symptoms of cognitive dysfunction in the past 4 weeks, with 29 (14.3%) having mild, 11 (5.4%) moderate, and 4 (2.0%) severe PROMIS Cognitive Function T-scores. In propensity score-weighted regression models, PROMIS Cognitive Function T-scores were inversely associated with patient-reported global AD severity, Patient Oriented Eczema Measure (POEM), Numeric Rating Scale worst itch and skin pain, SCORing Atopic Dermatitis (SCORAD)-sleep, POEM-sleep, Eczema Area and Severity Index, and SCORAD, with stepwise decreases of cognitive function with worsening AD severity. At all AD severity levels, cognitive dysfunction was associated with increased Dermatology Life Quality Index and ItchyQoL scores. Changes from baseline in PROMIS Cognitive Function T-scores were weakly to moderately inversely correlated with changes from baseline in multiple AD outcomes. LIMITATIONS: Single-center study without non-AD controls. CONCLUSION:Cognitive dysfunction is associated with AD severity. Cognitive function may be an important end point for monitoring treatment response in AD.
Authors: Marissa T Ayasse; Adnan Ahmed; Maria L Espinosa; Christina J Walker; Muhammad Yousaf; Jacob P Thyssen; Jonathan I Silverberg Journal: Arch Dermatol Res Date: 2020-11-22 Impact factor: 3.017