Neurologic impairment evaluation of patients with primary Sjögren’s syndrome: a cross-sectional study

In primary Sjögren’s Syndrome (pSS), neurologic involvement is not uncommon. We aim to determine the frequency of central and/or peripheral neurological involvement in patients with pSS and factors that influence neurological involvement. It was a retrospective cross-sectional study. 50 pSS patients, 50 controls were included. Neurological examinations, cognitive tests, Beck Depression Inventory (BDI), Fatigue Severity Scale (FSS), Leeds Assessment of Neuropathic Symptoms & Signs Pain Scale (LANSS), electromyography (EMG) were carried out on both groups. Neuroimaging and needle EMG were performed only in the patient group. The healthy controls did not undergo these procedures. 96% of the cases were female (median age 51.8 ± 8.21 years). Thirty-three (66%) of the cases had at least one neurologic complaint. The most common complaints were sensory symptoms including numbness, burning, and paresthesia in the extremities in 42%. In 46% of the cases, cranial MRI revealed lesions. The pSS group exhibited significantly higher scores in BDI, FSS. The pSS group had significantly lower values in comprehensive cognitive tests. This study represents the first application of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery to evaluate cognitive phenotypes in pSS. Unilateral entrapment neuropathy was found in 34% of the patients, while bilateral entrapment neuropathy was found in 8%. The occurrence of entrapment neuropathy was significantly higher in the pSS group ( p = 0,009). Electrophysiological parameters revealed no myopathic, polyneuropathic. The cutaneous silent period (CSP) responses were not detected significant differences to controls. Headache was observed in 36% ( n = 18) of cases. Depression, fatigue, cognitive impairment, carpal tunnel syndrome and headache were found more common in pSS patients. Consequently, in pSS patients, conducting a thorough neurological assessment to identify neurological manifestations is essential.