Table 1
Clinical, neurological and psychiatric features of the study population.
| VARIABLES* | VALUE | |
|---|---|---|
| Age (years) | 43.2 ± 10.8 | |
| Female gender | 42 (84) | |
| Schooling (years) | 8.5 ± 4.3 | |
| Time since diagnosis of rheumatic fever (years) | 9.0 [5/22] | |
| NYHA functional class | I/II | 38 (76) |
| III/IV | 12 (24) | |
| Systolic blood pressure (mmHg) | 111 ± 14 | |
| Diastolic blood pressure (mmHg) | 73 ± 10 | |
| 12-Item Short-Form Health Survey† | ||
| Physical Component Summary | 45.5 ± 9.9 | |
| Mental Component Summary | 44.4 ± 13.1 | |
| Neurological and psychiatric characteristics | ||
| Current or history of chorea‡ | 24 (48) | |
| Tics | 9 (18) | |
| Basal ganglia motor dysfunction§ | 18 (36) | |
| Obsessive-compulsive symptoms | 24 (48) | |
| Major depressive disorder | 17 (34) | |
| Generalized anxiety disorder | 27 (54) | |
| Seizures | 9 (18) | |
| Migraine | 26 (52) | |
| Cognitive complaints¶ | 33 (66) | |
[i] * Data are expressed as the mean value ± SD, median (interquartile range), or absolute numbers (percentage).
† Revised form of the 12-Item Short-Form Health Survey.
‡ Patients with chorea observed in current neurologic examination plus patients with well-documented history of Sydenham’s chorea.
§ Basal ganglia motor dysfunction includes patients with well-documented diagnosis of Sydenham’s chorea and patients with current chorea and/or tics.
¶Patients with subjective complaints about difficulties in attention, memory and execution/planning of daily tasks.
Figure 1
Flow chart of study population.
Table 2
Demographic and clinical features according to basal ganglia motor dysfunction.
| CLINICAL PARAMETERS* | PATIENTS WITHOUT BASAL GANGLIA MOTOR DYSFUNCTION (N = 32) | PATIENTS WITH BASAL GANGLIA MOTOR DYSFUNCTION (N = 18) | P VALUE |
|---|---|---|---|
| Age (years) | 45.7 ± 10.9 | 38.9 ± 9.4 | 0.032 |
| Female gender (n/%) | 26 (81) | 16 (89) | 0.694 |
| Schooling (years) | 8.5 ± 4.8 | 8.2 ± 3.5 | 0.685 |
| NYHA class III–IV (n/%) | 9 (28) | 3 (17) | 0.497 |
| Valvar intervention (n/%) | 30 (94) | 16 (89) | 0.612 |
| Mitral valve area (cm2) | 1.00 [0.83/1.40] | 0.90 [0.77/1.14] | 0.280 |
| Left ventricular ejection fraction (%) | 65 [57/69] | 66 [62/69] | 0.424 |
| Left atrial volume (mL/m2) | 55.5 [45/66] | 51.3 [47.6/59.2] | 0.534 |
| Atrial fibrillation (n/%) | 8 (25) | 2 (11) | 0.452 |
| Mitral mean gradient (mmHg) | 8.5 [6.5/14] | 9.5 [8/13.7] | 0.301 |
| Moderate/severe MR (n/%) | 2 (6) | 1 (6) | 1.000 |
| Systolic pulmonary AP (mmHg) | 37 [33/49] | 44 [33/68] | 0.275 |
| 12-Item Short-Form Health Survey§ | |||
| Physical Component Summary | 44.3 ± 10.6 | 47.5 ± 8.5 | 0.275 |
| Mental Component Summary | 47.2 ± 13.5 | 39.5 ± 11.3 | 0.043 |
[i] * Data are expressed as the mean value ± SD, median (interquartile range), or absolute numbers (percentage).
§ Revised form of the 12-Item Short-Form Health Survey.
AP = artery pressure; MR = mitral regurgitation.
Table 3
Neurological and psychiatric disorders according to basal ganglia motor dysfunction.
| NEUROLOGICAL AND PSYCHIATRIC CHARACTERISTICS* | PATIENTS WITHOUT BASAL GANGLIA MOTOR DYSFUNCTION (N = 32) | PATIENTS WITH BASAL GANGLIA MOTOR DYSFUNCTION (N = 18) | P VALUE |
|---|---|---|---|
| Obsessive-compulsive symptoms | 11 (34) | 13 (72) | 0.018 |
| Major depressive disorder | 7 (22) | 10 (56) | 0.028 |
| Generalized anxiety disorder | 13 (41) | 14 (78) | 0.018 |
| Seizures | 4 (13) | 5 (28) | 0.253 |
| Migraine | 14 (44) | 12 (67) | 0.149 |
| Cognitive complaints | 22 (69) | 11 (61) | 0.757 |
| Prescribed Drugs | |||
| Antidepressants | 3 (9) | 2 (11) | 1.000 |
| Anticonvulsants | 2 (6) | 3 (19) | 0.336 |
| Benzodiazepines | 0 (0) | 2 (11) | 0.125 |
| Validated Questionnaires | |||
| YBOCS score† | 0 [0/10.8] | 13 [0/24] | 0.004 |
| HADS ‡ Depression | 6.4 ± 4.8 | 8.7 ± 5.1 | 0.115 |
| Anxiety | 7.6 ± 5.0 | 9.9 ± 4.6 | 0.102 |
| MMSE Score¶ | 28 [25.5/30] | 26 [24.8/29] | 0.216 |
| Low MMSE Score£ | 8 (25) | 8 (44) | 0.211 |
| FAB score§ | 14.5 [12/16.8] | 14 [13/15.3] | 0.895 |
[i] * Data are expressed as the mean value ± SD, median (interquartile range), or absolute numbers (percentage).
† Yale-Brown obsessive-compulsive scale.
‡ Hospital Anxiety and Depression Scale.
¶ Mini-mental state examination.
£ MMSE scores below the cut-off proposed for Brazilian subjects, adjusted for schooling years.
§ Frontal assessment battery.