Cognitive function in chronic rhinosinusitis: a controlled clinical study

Abstract

Background: Cognitive dysfunction in patients with chronic rhinosinusitis (CRS) has previously received little attention. Cognitive data generally includes only subjective measures and lack appropriate controls when cognition is considered. The purpose of this study was to characterize dimensions of cognitive function that are affected in patients with CRS compared to a control sample using subjective and objective measures of cognitive function.

Methods: Patients fulfilling diagnostic criteria for CRS and non-CRS controls were recruited from the same clinical reference population. Patient-reported cognitive dysfunction was assessed using the Cognitive Failures Questionnaire (CFQ) and fatigue via the Fatigue Severity Scale (FSS). Objective cognitive function was assessed using a battery of tests from the Automated Neuropsychological Assessment Metrics (ANAM) computerized platform.

Results: A total of 100 subjects were enrolled, including 50 patients with active CRS and 50 control subjects. Patients with CRS scored significantly worse in subjective cognition as measured by total CFQ scores (38.3 ± 16.5 vs 30.9 ± 12.5; p = 0.009) and the FSS (4.2 ± 1.6 vs 3.0 ± 1.5; p = 0.001). Patients with CRS were also found to have worse simple reaction time scores compared to controls without CRS (162.4 ± 56.2 vs 193.0 ± 44.6; p = 0.003). These differences persisted regardless of polyp status. Performance differences for FSS and SRT measures remained significant after controlling for age, gender, race/ethnicity, education, allergic rhinitis, asthma, obstructive sleep apnea, depression, and antihistamine usage.

Conclusion: Patients with CRS report significantly more cognitive dysfunction and fatigue on validated instruments and had worse reaction times on computerized testing. Further study is necessary to determine whether available treatments impact these measures.

Keywords: attention; chronic rhinosinusitis; cognition; cognitive function; fatigue; memory.