Cognitive Impairment in Chronic Rhinosinusitis

摘要 认知障碍的特征是记忆、语言、思维或判断方面的问题。 尽管认知受损对生活质量和个人生活质量有着巨大的影响， 健康，除了我们的试点研究;与睡眠时间中断相关的认知功能受损 作为其潜在的机制，尚未在炎症患者中进行客观研究。 和过敏性呼吸道疾病如慢性鼻窦炎（CRS）。我们的KL-2支持 研究和初步数据显示，CRS患者存在显著的认知障碍 与睡眠障碍和睡眠时间变化相关的对照组相比。 利用我从KL 2获得的经验，这项拟议研究的总体目标是 目的：（1）表征健康对照和慢性阻塞性肺病患者的认知功能概况 上呼吸道炎症;并识别那些有认知受损风险的人;（2）识别 可预防的认知障碍风险因素，包括睡眠时间偏移，（3）测试 假设血清IL-6在这一过程中起作用，并可能作为认知障碍的生物标志物， CRS的缺陷。 我们已经招募了124名个体（69名CRS和55名对照）用于我们的试点数据，并将 计划招募额外的研究受试者并完成所有这些病例的数据采集， 对100名CRS患者和100名对照进行病例对照研究。 目的1将描述认知功能概况，分析6个领域的认知功能， 这项病例对照研究，将不同严重程度的CRS患者与匹配的健康人进行比较， 控制;还旨在确定CRS中认知障碍的风险因素。的潜在风险 我们计划研究的因素包括人口统计、社会经济和CRS严重程度因素;以及 CRS相关合并症（特应性、哮喘等）。 目标2的重点是测试睡眠时间变化与认知功能有关的假设 CRS的缺陷。睡眠时间的客观测量，包括7天活动记录仪和 将在100名以上CRS和100名对照中进行昼夜节律评估问卷 患者一种四步统计方法，其中进行了一系列回归分析 将用于检测CRS严重程度对认知功能的影响是否由以下因素介导： 睡吧 目的3旨在验证血清IL-6是认知障碍的有效生物标志物的假设 在CRS。为此，将测定血清IL-6水平并将其与认知变量相关， 患者，使用多变量统计模型。如果发现IL-6具有显著的介导作用， 然后将睡眠变量添加到回归分析中，以探索它们如何共同作用 影响IL-6与认知之间的关联。其他炎性细胞因子和可溶性 还将测量IL-6受体以检验相关假设。

Abstract Cognitive impairment is characterized by problems with memory, language, thinking or judgment. Despite the tremendous known impact of impaired cognition on quality of life and individuals' health, beside our pilot study; impaired cognitive function associated with sleep timing disruption as its potential mechanisms, has not been objectively investigated in patients with inflammatory and allergic respiratory diseases such as Chronic rhinosinusitis (CRS). Our KL-2 supported studies and preliminary data have shown significant cognitive impairment in CRS patients compared to controls that was associated with sleep disturbance and sleep timing changes. Leveraging experienced gained through my KL2, the overall objectives of this proposed study are to: (1) characterize cognitive function profile in both healthy controls and patients with chronic inflammation in upper airways ; and identify those at risk of impaired cognition; (2) identify the preventable risk factors of cognitive impairment including sleep timing shift, (3) test the hypothesis that serum IL-6 has a role in this process and may serve as a biomarker for cognitive impairment in CRS. We have already recruited 124 individuals (69 CRS and 55 controls) for our pilot data and will plan to recruit additional study subjects and complete the data acquisition for all these cases to perform a case control study of 100 CRS patients and 100 controls. Aim 1 will characterize the cognitive function profile analyzing 6 domains of cognitive function in this case-control study of patients with CRS of varied severity compared to matched healthy controls; and also aims to identify risk factors of cognitive impairment in CRS. The potential risk factors we plan to study include demographics, socioeconomic and CRS-severity factors; and CRS-related comorbidities (atopy, asthma, etc.). Aim 2 focuses to test the hypothesis that a sleep-timing shift is linked to cognitive function impairment in CRS. Objective measurements of sleep timing including 7 days actigraphy and circadian rhythm assessment questionnaires will be performed in above 100 CRS and 100 control patients. A four-step statistical approach in which a series of regression analysis are conducted will be applied to test whether the effect of CRS severity on cognitive function is mediated by sleep. Aim 3 focuses to test the hypothesis that serum IL-6 is a valid biomarker for cognitive impairment in CRS. For this aim serum IL-6 level will be determined and related to cognitive variables in patients, using a multi-variate statistical model. If IL-6 is found to have a significant mediation, then sleep variables will be added in the regression analysis to explore how they work together to affect the association between IL-6 and cognition. Other inflammatory cytokines and soluble IL-6 receptor will also be measured to test related hypotheses.