Abstract
Objective Depression is a common co-morbidity in asthma, worsening asthma control and impairing quality of life. Previous studies have reported a higher risk of cognitive deficit in depression, yet little research has focused on the level of cognition in asthmatic patients with depression. Evidence shows that inflammation may play an important role in both asthma and depression. Cerebral white matter injury, possibly induced by inflammation, has been associated with depression. This study assesses cognitive function in patients with asthma and a depression comorbidity, compared to patients with asthma only or depression only. Methods Four groups were studied: Asthma comorbid Depression group (A + D, n = 26), Depression group (D, n = 25), Asthma group (A, n = 33) and Normal controls (N, n = 28). Cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). Inflammatory cytokines were measured, including interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-mobility group box 1(HMGB1) and Netrin-1. Cerebral white matter injury was assessed by serum myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG), and their correlations with cognitive performance were calculated. Results A + D group showed the highest incidence of cognitive deficit, with the cognitive domain particularly affected. Compared to N group, serum levels of IL-6, HMGB1, Netrin-1, MBP and MOG were significantly elevated in A + D group. MOG level negatively correlated with the MoCA score. Conclusion Patients with comorbidities presented with more severe cognitive deficits and higher levels of inflammatory cytokines. Cerebral white matter injury may account for the cognitive deficit in patients and MOG could be a potential biomarker for this process.
Highlights
Asthma is a common chronic disease characterized by bronchial hypersensitivity and airway inflammation, resulting in reversible airflow obstruction
Compared to N group, serum levels of IL-6, highmobility group box 1 (HMGB1), Netrin-1, myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG) were significantly elevated in A + D group
Cerebral white matter injury may account for the cognitive deficit in these patients and MOG could be a potential biomarker of this process
Summary
Asthma is a common chronic disease characterized by bronchial hypersensitivity and airway inflammation, resulting in reversible airflow obstruction. A total of 334 million people worldwide suffer from this disorder, causing huge burden on society and individuals.[1] Evidence has shown that patients with asthma had 1.52 times higher risk of developing depression as compared with those not having asthma, and depressive patients had an increased risk for asthma (OR 3.2) as compared with those not having depression.[2] The comorbidity of asthma and depression is associated with poorer symptom control, impairing patient’s quality of life.[3]. Depression has been considered as an important modifiable risk factor of dementia[5] and to predict conversion from any-type of mild cognitive impairment to all-cause dementia.[6] few research has focused on the cognitive status of asthmatic patients with depression. The present study aimed to assess the cognitive function and explore the potential mechanism in patients with asthma, depression and comorbidity
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