Does Ankylosing Spondylitis Affect the Brain?

Ankylosing spondylitis can affect the way your brain works. It can cause problems with thinking, remembering, and concentrating. The effect can worsen over time and prevent you from taking care of yourself.

This article describes how the disease impacts your brain, how it can affect the way your brain functions, and how to handle the brain-related symptoms that occur.

Does Ankylosing Spondylitis Affect the Brain?

Ankylosing spondylitis is a lifelong illness that can worsen over time. As the condition progresses, its impact can spread and affect your brain.

The consequences of ankylosing spondylitis on the brain vary by individual. Symptoms can range from subtle to severe. Though many symptoms may be overlooked in their earliest stages, symptoms that occur in advanced stages of the disease can interfere with your ability to communicate and live normally.

Brain Fog

Brain fog, more formally called cognitive dysfunction, describes a feeling of mental sluggishness resulting from another health condition, like ankylosing spondylitis. It can affect your ability to think, concentrate, or make decisions normally.

Brain fog involves a decline in your ability to focus and may make it difficult to perform one or more of the following areas of cognitive functions:

• Attention and concentration
• Verbal and nonverbal learning
• Short-term and working memory
• Visual and auditory processing
• Problem-solving
• Motor functioning
• The ability to process and/or respond to information
  

Memory Loss

Though gradual memory loss occurs naturally with age, it can also be linked to inflammatory conditions like ankylosis spondylitis. Symptoms can range from unusual forgetfulness to difficulty remembering common people and situations.

Memory loss can include the following symptoms:

• Losing objects often
• Trouble finishing a complete thought or sentence
• An inability to keep track of time, people, and places
• Asking the same questions repeatedly
• Forgetting to attend important appointments or events
• Getting lost in places you know well
• Trouble following directions or recipes
• An inability to maintain self-care
• Engaging in unsafe behavior

Brain Lesions

Brain lesions are abnormalities in your brain. They can occur as a result of many factors, including inflammation. The impact of brain lesions depends on their location and the specific role of that area in the brain.

Brain lesions can affect small or large areas of your brain, depending on the size and number of lesions present. You may have significant focal neurological deficits like weakness of the face, arm, and leg on one side if you have a large brain lesion. Behavioral changes, cognitive dysfunction, fatigue, and/or dizziness, along with one or more focal neurological deficits, can occur when multiple lesions develop.

Causes of Cognitive Dysfunction

Research indicates that having ankylosing spondylitis can make you more vulnerable to cognitive dysfunction. Though the mechanism that triggers the decline in cognitive function isn't clear, several factors common to ankylosing spondylitis may increase your risk of having problems with normal brain function.

Chronic Inflammation

Ankylosing spondylitis causes chronic inflammation, primarily affecting the spine and sacroiliac joint in your lower back. However, a study that used functional magnetic resonance imaging (MRI) to assess ankylosing spondylitis found that people with the disease had "widespread brain connectivity alterations" that aligned with blood markers for inflammation, versus the results of a control group.

Cognitive dysfunction has been linked to inflammation. Though inflammation is a protective response that promotes healing, prolonged higher levels of inflammation can lead to the release of damaging enzymes that can harm brain cells. This effect can damage brain structures that play key roles in cognitive processes such as attention, memory, emotion, and perception.

Chronic Pain

Chronic pain is a common symptom of ankylosing spondylitis. Research shows that people with the disease have a 33% higher risk of fibromyalgia, a condition characterized by pain and tenderness throughout the body. Issues with fatigue, sleep deprivation, memory loss, and mood disorders commonly accompany fibromyalgia.

Regardless of its source, chronic pain is linked with accelerated cognitive decline and a higher probability of dementia versus people who do not have persistent pain. In addition, the rate of cognitive decline increases in response to pain severity.

Medications

Cognitive dysfunction can occur as a side effect of some over-the-counter and prescription medications for ankylosing spondylitis and many other conditions. It can also occur as the result of the interaction of two or more drugs taken together.

Because there is no cure for ankylosing spondylitis, you may use a variety of medications to treat different symptoms as the disease changes and progresses. The effect can create an ongoing risk of cognitive dysfunction from new medications or changing doses.

The following commonly prescribed drugs are linked to memory loss and mental dysfunction:

• Anticholinergics: Anticholinergic medications block the neurotransmitter acetylcholine to treat many conditions, such as depression, insomnia, allergies, urinary incontinence, and heart disease.
• Psychoactive drugs: Psychoactive drugs change your mental state. They include depressants, tranquilizers, opioids, stimulants, and marijuana.
• Antidepressants: Antidepressants reduce the symptoms of depression and other mental health conditions.
• Anticonvulsants: Anticonvulsants are anti-seizure drugs that can also reduce some types of chronic pain.
• Histamine H2 receptor antagonists: Histamine H2 receptor antagonists reduce the production of stomach acid to help relieve heartburn and other symptoms of gastroesophageal reflux disease (GERD) and stomach ulcers.
• Corticosteroids: Corticosteroids can help reduce inflammation and relieve the pain and swelling that often occurs with ankylosing spondylitis.
• Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs can reduce pain, swelling, and inflammation. These drugs often serve as over-the-counter treatments.
• Cardiac medications: Cardiac medications that cause cognitive dysfunction include statins and other drugs that can lower cholesterol.

Poor Sleep

Adequate sleep is essential for normal, healthy cognitive function. Sleep experts recommend that adults get an average of eight hours of sleep, though that amount can vary by individual.

Sleep disturbances resulting in poor sleep quality are significantly higher in people with ankylosing spondylitis versus those without the disease. According to one study, about 58% of people with ankylosing spondylitis report sleep disturbances.

Factors including altered posture and nighttime inflammatory pain likely contribute to the frequency of sleep disturbances in people with ankylosing spondylitis. Research indicates that people with the highest level of disease activity are likely to have the worst sleep quality.

Losing just a few hours of quality sleep can interfere with the following cognitive processes:

• Attention
• Language
• Reasoning
• Decision-making
• Learning
• Memory

Depression and Anxiety

Research indicates that people with ankylosing spondylitis have a 51% higher risk of depression and an 85% higher risk of anxiety versus people who don't have the disease.

The link between ankylosing spondylitis and these mental health conditions may be related to the disease's symptoms, including chronic pain, impaired physical function, and fatigue. People with ankylosing spondylitis are more likely to have depression and anxiety if they have high disease activity, impaired physical functioning, fatigue, and/or lower quality of life.

Studies indicate that depression, anxiety, and anger are linked with cognitive dysfunction and a higher risk of dementia. A mood disorder like depression or anxiety may also accelerate the natural cognitive decline that occurs with aging.

Managing Brain-Related AS Symptoms

If you recognize brain-related symptoms of ankylosing spondylitis, contact your healthcare provider for a consultation. Be open and honest about your symptoms and how they affect your quality of life.

Ensure they are aware of all your medications, even over-the-counter products and those you take for other conditions. Identifying the cause of your problem is the first step in getting the right treatment and reducing long-term damage.

In addition to the instructions you receive from your healthcare provider, consider these steps to ensure that you're doing all you can to manage your symptoms:

• Get adequate quality sleep.: Establish and maintain a nightly sleep routine. Prepare a room that is cool, dark, and comfortable. Don't consume late-day caffeine products or late-night snacks. Avoid using any screens at least an hour before you sleep.
• Maintain a regular workout schedule: Many exercises are inked with improved brain function. Walking, yoga, high-intensity exercise, and resistance training have benefits for both your mind and body.
• Eat a healthy diet: Assess your diet and modify it as needed to eat more fruits, vegetables, healthy fats, and lean protein. Limit alcohol, caffeinated products, and processed sugar.
• Record when symptoms occur: Identify patterns of cognitive dysfunction so you can schedule tasks at times when your mental abilities are at their best. Keep your healthcare provider informed about any changes in the timing or onset of brain fog.
  

When to See a Healthcare Provider

Memory loss and other symptoms of cognitive dysfunction can occur for many reasons, It's important to keep your healthcare provider informed of any new symptoms of cognitive dysfunction at your regular checkups.

Some symptoms of cognitive dysfunction require prompt care. Contact your healthcare provider immediately if you have brain fog or memory loss with any of the following symptoms:

• Persistent headaches
• Blackouts
• Constant tingling or numbness in your arms or legs
• Memory lapses
• Erratic sleeping habits

Summary

Ankylosing spondylitis is a chronic inflammatory disease that often causes pain in your back, hips, and other joints. It can also affect your brain and your ability to perform normal functions.

These changes can cause brain fog, memory loss, or brain lesions. They can affect the way your brain thinks, remembers, and concentrates. Though the symptoms can be subtle when they start, they can become more severe over years as the disease changes.

Finding the cause of brain-related symptoms can help improve the problem. Factors like pain, inflammation, drugs, or poor sleep can be the source of these symptoms. Making the necessary changes can often help reduce symptoms and improve mental function.

A Word From Verywell

Dealing with brain-related symptoms of ankylosing spondylitis can feel overwhelming. On its own, ankylosing spondylitis is a challenging condition that can impact your daily routines and quality of life. Adding symptoms of cognitive dysfunction to your condition may mean asking for help at a time when you may be eager to remain independent.

Don't delay seeking support. Talk to your healthcare provider about ways to reduce symptoms that are affecting the ways you think and concentrate. Until your problems improve, do what is necessary to remain healthy and safe. You'll be at your best if you work to reduce the likelihood of painful flare-ups and avoid dangerous injuries from falls or other unsafe events.