A reconciling hypothesis centered on brain-derived neurotrophic factor to explain neuropsychiatric manifestations in rheumatoid arthritis.

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Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease characterized by synovitis leading to joint destruction, pain and disability. Despite efficient antirheumatic drugs, neuropsychiatric troubles including depression and cognitive dysfunction are common in RA but the underlying mechanisms are unclear. However, converging evidence strongly suggested that deficit in brain-derived neurotrophic factor (BDNF) signalling contributes to impaired cognition and depression. Therefore, this review summarized the current knowledge on BDNF in RA, proposed possible mechanisms linking RA and brain BDNF deficiency including neuroinflammation, cerebral endothelial dysfunction and sedentary behavior and discussed neuromuscular electrical stimulation as an attractive therapeutic option.

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