Cognitive impairment in deforming osteoarthritis
DOI: 10.32364/2587-6821-2024-8-2-9
E.V. Ekusheva1,2, N.N. Kalinina3, E.V. Parkhomenko4, E.V. Khozhenko1
1Academy of Postgraduate Education of the Federal Scientific and Clinical Center of the Federal Medical Biological Agency of Russian Federation, Moscow, Russian Federation
2Belgorod State University, Belgorod, Russian Federation
3Tver State Medical University, Tver, Russian Federation
4Altai State Medical University, Barnaul, Russian Federation
Deforming osteoarthritis is characterized by chronic pain, which is often associated with a wide range of cognitive impairment (CI) due to the involvement of common anatomical structures, similar plastic disorders in brain neuronal systems, depletion of common mediators and neurochemicals, and general neurochemical changes leading to maladaptive neuroplasticity in cerebral systems of pain control and key cognitive functions. In the management of patients with deforming osteoarthritis, it is important to focus on treating chronic pain and CI, as it determines long-term treatment success and significantly affects quality of life and daily, social, and occupational activities. We describe a patient with deforming osteoarthritis, chronic pain, and CI who required an individualized, complex treatment approach. This case report illustrates the reduction in pain severity and the improvement in quality of life and cognitive function achieved with timely initiation of pathogenically targeted treatment.
Keywords: osteoarthritis, deforming osteoarthritis, chronic pain, cognitive impairment, maladaptive neuroplasticity, Brainmax.
For citation: Ekusheva E.V., Kalinina N.N., Parkhomenko E.V., Khozhenko E.V. Cognitive impairment in deforming osteoarthritis. Russian Medical Inquiry. 2024;8(2):110–114 (in Russ.). DOI: 10.32364/2587-6821-2024-8-2-9.
Evgenia V. Ekusheva — Dr. Sc. (Med.), Professor, Head of the Department of Neurological Diseases and Neurorehabilitation, Academy of Postgraduate Education of the Federal Scientific and Clinical Center of the Federal Medical Biological Agency of Russian Federation; 91, Volokolamskoe road, Moscow, 125371, Russian Federation; senior researcher of the Laboratory "Issues of Ageing", Belgorod State University; 85, Pobedy str., Belgorod, 308015, Russian Federation; ORCID iD 0000-0002-3638-6094.
Natalya N. Kalinina — C. Sc. (Med.), assistant of the Department of Hospital Therapy, Tver State Medical University; 4, Sovetskaya str., Tver, 170100, Russian Federation; ORCID iD 0009-0007-9615-2779.
Ekaterina V. Parkhomenko — C. Sc. (Med.), Associate Professor, associate professor of the Department of Neurology and Neurosurgery with the Course of Additional Professional Education, Altai State Medical University; 40, Lenin str., Barnaul, 656038, Russian Federation; ORCID iD 0000-0003-0489-9845.
Elena V. Khozhenko — Dr. Sc. (Med.), professor of the Department of Neurological Diseases and Neurorehabilitation, Academy of Postgraduate Education of the Federal Scientific and Clinical Center of the Federal Medical Biological Agency of Russian Federation; 91, Volokolamskoe road, Moscow, 125371, Russian Federation; ORCID iD 0000-0003-0313-1754.
Contact information: Evgenia V. Ekusheva, e-mail: ekushevaev@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 02.02.2024.
Revised 26.02.2024.
Accepted 19.03.2024.
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25. Екушева Е.В. Клинические портреты «типичных» пациентов в практике невролога. Consilium Medicum. 2019;21(9):131–135. DOI: 10.26442/20751753.2019.9.190646. Ekusheva E.V. Clinical portraits of "typical" patients in the practice of a neurologist. Consilium Medicum. 2019;21(9):131–135 (in Russ.). DOI: 10.26442/20751753.2019.9.190646.
2. Classification of Chronic Pain. Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Merskey H., Bogduk N., eds. 2nd ed. Seattle: IASP Press. 1994:209–214.
3. Екушева Е.В. Когнитивные нарушения у пациентов с хроническим болевым синдромом. РМЖ. Медицинское обозрение. 2020;4(9):573–577. DOI: 10.32364/2587-6821-2020-4-9-573-577. Ekusheva E.V. Cognitive impairment in patients with chronic pain syndrome. Russian Medical Inquiry. 2020;4(9):573–577 (in Russ.). DOI: 10.32364/2587-6821-2020-4-9-573-577.
4. Morone N.E., Abebe K.Z., Morrow L.A., Weiner D.K. Pain and decreased cognitive function negatively impact physical functioning in older adults with knee osteoarthritis. Pain Med. 2014;15(9):1481–1487. DOI: 10.1111/pme.12483.
5. Hart R.P., Wade J.B., Martelli M.F. Cognitive impairment in patients with chronic pain: the significance of stress. Curr Pain Headache Rep. 2003;7(2):116–126. DOI: 10.1007/s11916-003-0021-5.
6. McCracken L.M., Iverson G.L. Predicting complaints of impaired cognitive functioning in patients with chronic pain. J Pain Symptom Manage. 2001;21(5):392–396. DOI: 10.1016/s0885-3924(01)00267-6.
7. Severeijns R., Vlaeyen J.W., van den Hout M.A., Weber W.E. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17(2):165–172. DOI: 10.1097/00002508-200106000-00009.
8. Malfliet A., Coppieters I., Van Wilgen P. et al. Brain changes associated with cognitive and emotional factors in chronic pain: A systematic review. Eur J Pain. 2017;21(5):769–786. DOI: 10.1002/ejp.1003.
9. Apkarian A., Sosa Y., Sonty S. et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci. 2004;24(46);10410–10415. DOI: 10.1523/JNEUROSCI. 2541-04.2004.
10. Baliki M., Schnitzer T., Bauer W., Apkarian A.V. Brain morphological signatures for chronic pain. PLoS One. 2011;6(10):e26010. DOI: 10.1371/ journal.pone.0026010.
11. Moriarty O., McGuire B., Finn D. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol. 2011;93(3):385–404. DOI: 10.1016/j.pneurobio.2011.01.002.
12. Landrø N.I., Fors E.A., Våpenstad L.L. et al. The extent of neurocognitive dysfunction in a multidisciplinary pain centre population. Is there a relation between reported and tested neuropsychological functioning? Pain. 2013;154(7):972–977. DOI: 10.1016/j.pain.2013.01.013.
13. Berryman C., Stanton T.R., Bowering K.J. et al. Evidence for working memory deficits in chronic pain: a systematic review and meta-analysis. Pain. 2013;154(8):1181–1196. DOI: 10.1016/j.pain.2013.03.002.
14. Veldhuijzen D.S., Kenemans J.L., van Wijck A.J. et al. Processing capacity in chronic pain patients: a visual event-related potentials study. Pain. 2006;121(1–2):60–68. DOI: 10.1016/j.pain.2005.12.004.
15. Schiltenwolf M., Akbar M., Hug A. et al. Evidence of specific cognitive deficits in patients with chronic low back pain under long-term substitution treatment of opioids. Pain Physician. 2014;17(1):9–20. PMID: 24452649.
16. Nekovarova T., Yamamotova A., Vales K. et al. Common mechanisms of pain and depression: are antidepressants also analgesics? Front Behav Neurosci. 2014;8:99. DOI: 10.3389/fnbeh.2014.00099.
17. Uçeyler N., Valenza R., Stock M. et al. Reduced levels of antiinflammatory cytokines in patients with chronic widespread pain. Arthritis Rheum. 2006;54(8):2656–2664. DOI: 10.1002/art.22026.
18. Naser P., Kuner R. Molecular, cellular and circuit basis of cholinergic modulation of pain. Neurosci. 2018;387:135–148. DOI: 10.1016/j.neuroscience. 2017.08.049.
19. Путилина М.В. Новые возможности комплексных препаратов в терапии цереброваскулярных заболеваний. Лечебное дело. 2022;3/4:15–22. DOI: 10.24412/2071-5315-2022-12914. Putilina M.V. New possibilities of complex drugs in the treatment of cerebrovascular diseases. Lechebnoye delo. 2022;3/4:15–22 (in Russ.). DOI: 10.24412/2071-5315-2022-12914.
20. Olianas M.C., Dedoni S., Onali P. Protection from interferon-beta-induced neuronal apoptosis through stimulation of muscarinic acetylcholine receptors coupled to ERK1/2 activation. Br J Pharmacol. 2016;173(19):2910–2928. DOI: 10.1111/bph.13570.
21. Торшин И.Ю., Громова О.А., Сардарян И.С., Федотова Л.Э. Сравнительный хемореактомный анализ мексидола. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017;1(2):75–83. DOI: 10.17116/jnevro20171171275-84. Torshin I.Yu., Gromova O.A., Sardaryan I.S., Fedotova L.E. Comparative chemoreactome analysis of mexidol. S.S. Korsakov Journal of Neurology and Psychiatry. 2017;1(2):75–83 (in Russ.). DOI: 10.17116/jnevro20171171275-84.
22. Avolio E., Mahata S.K., Mantuano E. et al. Antihypertensive and neuroprotective effects of catestatin in spontaneously hypertensive rats: interaction with GABAergic transmission in amygdala and brainstem. Neuroscience. 2014;270:48–57. DOI: 10.1016/j.neuroscience.2014.04.001.
23. Lin N.H., Gunn D.E., Ryther K.B. et al. Structure-activity studies on 2-methyl-3-(2(S)-pyrrolidinylmethoxy) pyridine (ABT-089): an orally bioavailable 3-pyridyl ether nicotinic acetylcholine receptor ligand with cognition-enhancing properties. J Med Chem. 1997;40(3):385–390. DOI: 10.1021/jm960233u.
24. Nakamura M., Jang I.S. Muscarinic M4 receptors regulate GABAergic transmission in rat tuberomammillary nucleus neurons. Neuropharmacology. 2012;63(6):936–944. DOI: 10.1016/j.neuropharm.2012.07.007.
25. Екушева Е.В. Клинические портреты «типичных» пациентов в практике невролога. Consilium Medicum. 2019;21(9):131–135. DOI: 10.26442/20751753.2019.9.190646. Ekusheva E.V. Clinical portraits of "typical" patients in the practice of a neurologist. Consilium Medicum. 2019;21(9):131–135 (in Russ.). DOI: 10.26442/20751753.2019.9.190646.
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