| Objective:(1)Gout closely relates to the mental disorder,like anxiety and depression.However,rare study focuses on the dispositional optimism in patients with gout until now.Therefore,this study assessed the dispositional optimism in gout patients.Furthermore,the relationship between this psychological phenomenon and compliance to urate-lowing therapy(ULT)was also investigated,while we attempted to seek the contributors to dispositional optimism.(2)Resting-state functional magnetic resonance imaging(rs-fMRI)is utilized to investigate whether the dispositional optimism of gout patients have some typical features in brain function.Methods:(1)A total of 530 gout patients,324 ankylosing spondylitis(AS)patients,60 rheumatoid arthritis(RA)patients and 174 healthy volunteers from the Guangdong Second Provincial General Hospital in August 2018 to November 2019 were included in this study.The demographic information was collected,including age,gender and education.Dispositional optimism,anxiety and depression of participants were measured by life orientation test revised version(LOT-R),self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively.Clinical information of gout patients was recorded,including disease duration,tophi and comorbidity.The pain of the involved joints was assessed by the visual analog scale(VAS).Serum uric acid(SUA)was collected at baseline and the last examination within the follow-up.Compliance to ULT was investigated using the medication possession ratio(MPR)in 3 months.Poor compliance was defined as MPR<0.8,while good compliance was defined as MPR?0.8.Spearman correlation analysis was used to investigate the relationship between dispositional optimism and features of gout patients.The contributors to dispositional optimism were analyzed by multivariate logistic regression.(2)Among the gout patients and healthy volunteers,37 gout patients and 36 age and gender-matched healthy people were willing to have brain functional imaging examination.The brain rs-fMRI was performed through the 3.0T MRI system.The rs-fMRI data was pretreated and presented by SPM8 and RSET software.A t-test was used to investigate the differences in amplitude of low-frequency fluctuation(ALFF)values between groups.The ALFF results were corrected by AlphaSim.Spearman test was performed to explore the correlation between ALFF values of different brain regions and clinical,psychological variables.Results:(1)The LOT-R score of gout patients was higher than AS patients(18.8±2.4 vs.17.5±1.9,p<0.05)and RA patients(18.8±2.4 vs.17.8±2.9,p<0.05).There was no significant difference of LOT-R score between the gout patients and the healthy controls(18.8±2.4 vs.19.1±2.4,p>0.05).Of the 530 gout patients,292(55.1%)had MPR<0.8.The LOT-R score of gout patients negatively correlated with MPR(r=-0.393,p<0.05).Level of education(OR=0.249,p<0.05)and comorbidities(OR=0.444,p<0.05)are the contributors to dispositional optimism in gout patients.(2)Compared to healthy controls,ALFF of bilateral temporal increased in gout patients(p<0.05),while it decreased in the vermis and left supplementary motor area(p<0.05).The ALFF of vermis positively related to LOT-R(r=0.428,p<0.05).Besides,the ALFF of left supplementary motor area negatively associated with VAS(r=-0.482,p<0.05).No significant correlation between ALFF of other abnormal regions and clinical,psychological variables was found(p>0.05).Conclusions:(1)The dispositional optimism of gout patients is similar to healthy controls,but significantly higher than AS and RA patients.(2)Dispositional optimism of gout patients negatively correlates with compliance to ULT.Level of education and comorbidities are the contributors to dispositional optimism in gout patients.(3)Compared to healthy controls,gout patients show increased neuronal activity in the bilateral temporal and decreased neuronal activity in the vermis and left supplementary motor area.(4)The neuronal activity of vermis positively correlates with dispositional optimism,while the neuronal activity of left supplementary motor area negatively correlates with the pain of the involved joints. |
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