Fatigue and depression in Behçet’s disease: Association with cranial Doppler ultrasound parameters and clinical activity

Objective. Fatigue and depression cause a psychological burden in patients with Behçet’s disease (BD) and may be associated with altered cerebral hemodynamics. Therefore, their assessment and relationship with cranial ultrasonographic parameters and disease activity were evaluated. Materials and methods. This study recruited 97 BD patients and 52 matched controls. Short Form-36 (SF-36), Multidimensional Assessment of Fatigue (MAF), and Beck’s Depression Inventory (BDI) questionnaires were used to assess fatigue and depression. Transcranial Doppler (TCD) was performed to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (V), and resistivity index (RI) in the common and internal carotid arteries (CCA and ICA), vertebral artery (VA), basilar artery, and the anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA). Disease activity was assessed by the BD Current Activity Form (BDCAF). Results. Patients had significantly lower SF-36 scores (median: 52.9 vs. 87.9; p<0.001) and higher MAF and BDI scores than controls (median: 28.5 vs. 1; p < 0.001 and 12 vs. 6; p < 0.001). MAF and BDI were significantly correlated, while SF-36 was inversely correlated with BDCAF (p < 0.001). TCD revealed higher V compared to controls in the left ICA, ACA, MCA, and the right and left VA intracranial segments (p = 0.005, p = 0.016, p = 0.029, p = 0.009, and p = 0.027). Significant associations were found between RI in the right CCA with SF-36 and BDI (B = -53.42, p = 0.011; B = 21.78, p = 0.038), PSV in left VA1 with MAF (B = 0.28, p = 0.001), and PSV in the right CCA and EDV in the left PCA with BDCAF (B = 0.06, p = 0.006 and B = 0.14, p = 0.046). Conclusions. TCD is a useful non-invasive tool for evaluating neurovascular and psychological burden in BD.