SSc May Be Linked to Subtle Cognitive Changes

Cross-sectional study finds domain-specific differences and higher anxiety without global impairment.

By
Andrea Surnit
April 30, 2026
3 min

Conexiant

Overview

Patients with systemic sclerosis (SSc) exhibit subtle differences in specific cognitive domains, particularly executive functions, without evidence of global cognitive impairment. Additionally, higher anxiety levels were noted in SSc patients compared to healthy controls.

Background

Systemic sclerosis is a chronic autoimmune disease that may affect multiple organ systems, including the central nervous system. Cognitive impairment in autoimmune diseases is an area of growing interest, with prior studies focusing on global cognitive decline. This study aimed to evaluate cognitive performance across specific domains in patients with SSc compared to rheumatoid arthritis patients and healthy controls.

Data Highlights

Measure	SSc (n=30)	RA (n=40)	Controls (n=30)
Mean MoCA Score	Not significantly different across groups	Not significantly different	Not significantly different
Percentage scoring below MoCA threshold (26)	53%	Not reported	Not reported
TMT-B Completion Time (seconds)	114	96	68
WAIS Error Rates	Higher than controls	Comparable to SSc	Lower than SSc
Anxiety (STAI Trait)	Higher than controls	Comparable to SSc	Lower than SSc
Depression (BDI Scores)	Similar to controls	Not reported	Similar to SSc

Key Findings

Global cognitive performance measured by MoCA was similar across SSc, RA, and healthy controls.
53% of SSc patients scored below the conventional MoCA threshold for normal cognition.
SSc patients required significantly more time to complete executive function tasks (e.g., TMT-B) compared to controls and RA patients.
SSc patients showed longer completion times on Stroop-based tasks and made more errors on WAIS processing speed tasks than controls.
Anxiety levels, particularly trait anxiety, were higher in SSc patients compared to healthy controls, while depression scores were similar.
Cognitive performance correlated with age, sex, alcohol intake, interstitial lung disease, and antinuclear antibody positivity but not with depression or anxiety scores.

Clinical Implications

Clinicians should be aware that patients with systemic sclerosis may experience subtle impairments in executive cognitive functions despite normal global cognitive screening results. Elevated anxiety levels in these patients warrant attention and may require targeted management. Routine cognitive screening in SSc might benefit from including domain-specific assessments to detect subtle deficits.

Conclusion

This study suggests that systemic sclerosis is associated with subtle domain-specific cognitive changes, particularly in executive functions, rather than global cognitive impairment. Higher anxiety levels are also characteristic of SSc patients compared to healthy controls.