The Montreal Cognitive Assessment Test (MoCA) test is a one-page, easy-to-administer, short test, which was first developed to detect mild cognitive dysfunction in the elderly. 5, 6 Previous studies did not mention a specific test for detecting cognitive dysfunction in PSS in addition, some cognitive tests are expensive and time-consuming. 11- 13 Similarly, some studies found a relationship between cognitive impairment and white matter lesions (WMLs), 14 whereas this was not supported in other studies. 11 Increased white matter abnormality was defined in PSS patients however in some studies, it was not different from the normal population.
Magnetic resonance imaging (MRI) is a potent predictor of subclinical tissue damage and the spread of CNS involvement in Sjögren’s patients. 3- 5 Cognitive impairment in PSS was reported to be associated with frontal-subcortical dysfunctions including attention, memory, information processing speed and executive functions. Cognitive impairment is also a common non-focal symptom of CNS involvement. The type and prevalence of CNS involvement should also be discussed in the evaluation of Sjögren’s syndrome. Neurological involvement occurs in the form of peripheral and central nervous system (CNS) involvement. Neurology studies have also observed high levels of neurological involvement. This difference was ascribed to the use of different diagnostic criteria in the diagnosis of PSS and different populations with distinct genetic and environmental factors. 1 Neurological involvement in PSS has been reported to occur in 8.5-70% of cases. Primary Sjögren’s syndrome (PSS) is a common autoimmune disease characterized by lymphocytic infiltration of exocrine glands without other systemic autoimmune diseases.