A0250 - Development and Validation of Brain Fog Questionnaire in Patients and Healthy Volunteers

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Asad Jehangir, MD

MD
Augusta, GA

Award: Presidential Poster Award

Asad Jehangir, MD¹, Eula P. Tetangco, MD, MPH², Adil Ghafoor, MD³, Yun Yan, PhD⁴, Amanda Laufer, PA-C⁴, Tennakoon Karunaratne, MD⁴, Brooke Inman, BSc³, Amol Sharma, MD⁴, Satish Rao, MD⁴
¹MD, Augusta, GA; ²Deaconess Clinic, Newburgh, IN; ³Medical College of Georgia, Augusta, GA; ⁴Augusta University, Augusta, GA

Introduction: Brain fogginess (BF) encompasses a constellation of neurocognitive symptoms that remain poorly characterized, in part due to its multidimensional symptoms. They are increasingly seen in gastroenterology patients, particularly those with gas, bloating and distension. We developed and psychometrically tested a 19-item questionnaire that described symptoms of importance to both patients and clinicians (Tetangco et al, ACG 2020). After due input from patients and clinicians, weightage analysis and item reduction, a 15-item new BF questionnaire (BFQ) was developed. Our aim here was to perform a preliminary comparative analysis of BFQ in patients with BF and healthy controls.

Methods: In this Phase II questionnaire study, patients with unexplained abdominal gas, bloating, distension, and symptoms of BF for ≥3 months completed the 15-item BFQ using a visual analogue scale, and a 10-item Gas and Bloating validated questionnaire at baseline and 2-weeks. The patients also completed Montreal Cognitive Assessment (MoCA) and Digital Symbol Substitution test (DSST). Healthy controls were invited to complete the aforementioned questionnaires. Data were compared for test-retest reliability, and between the two groups.

Results: Ten patients (8 females, mean age 44.4 years), and 12 healthy controls (5 females, mean age 42.8 years) participated. The most severe visual analogue scores for BF symptoms that were reported by patients included feeling sleepy (5.8±0.9), being easily distracted (5.8±1.0), and having difficulty focusing (5.5±0.9). The patients had a significantly higher BFQ total score compared to healthy controls (65.6±9.0 vs 9.8±4.1, p< 0.001), with all 15 BFQ items significantly higher than healthy controls on BFQ (Table 2). There was no significant difference in DSST scores (42.8±6.6 vs 61.5±17.6, p=0.065) or MoCA scores (25.6±0.9, vs 24.9±3.3, p=0.957) between the two groups. The BFQ had a good test-retest reliability (ICC=0.78, p=0.017) for 9/15 BFQ items.

Discussion: The 15-item BFQ comprehensively captures key symptoms of BF and significantly differentiates healthy controls from BF patients. Also, the lack of difference in MoCA and DSST scores between BF patients and healthy controls suggests that these patients do not have cognitive impairment. The BFQ has good test-retest reliability, but therapeutic responsiveness requires further study.

Brain Fog Questionnaire	Patients				HVs	p value (Pts vs HVs)
Brain Fog Questionnaire	Baseline questionnaire	2-week questionnaire	ICC	p value	HVs	p value (Pts vs HVs)
I am forgetful and/or experience short-term memory loss	4.5±0.9	4.4±0.7	0.500	0.160	1.0±0.5	0.001
I have difficulty thinking	4.4±0.6	4.8±0.7	0.835	0.007	0.7±0.4	< 0.001
I have difficulty focusing	5.5±0.9	5.2±0.7	0.817	0.009	1.1±0.7	0.001
I feel cloudy and/or spacey	5.4±1.0	5.3±0.9	0.878	0.002	0.6±0.4	< 0.001
I have difficulty finding the right word(s) to communicate	3.8±0.9	3.6±0.6	0.665	0.059	0.6±0.3	0.003
I have difficulty understanding what others say	2.8±0.6	3.0±0.7	0.364	0.255	0.2±0.1	0.001
I feel mentally fatigued and/or exhausted	5.3±1.0	5.0±1.0	0.764	0.021	0.9±0.3	< 0.001
I feel that I am slow	3.6±0.9	3.5±0.8	0.784	0.016	0.6±0.4	0.009
My mind goes blank	4.4±0.9	4.2±0.9	0.170	0.393	0.9±0.5	0.003
I am easily distracted	5.8±1.0	4.9±0.9	0.853	0.004	1.3±0.7	0.002
I have difficulty understanding words that I have read	3.5±0.9	2.6±0.7	0.872	0.003	0.2±0.1	0.003
I experience confusion	4.0±1.1	3.9±0.9	0.882	0.002	0.2±0.1	0.001
I feel sleepy	5.8±1.0	5.4±0.8	0.747	0.027	0.8±0.3	< 0.001
I feel that my thoughts are moving too quickly	3.3±0.9	3.6±1.0	0.463	0.184	0.2±0.2	0.001
I go somewhere to do something, but cannot remember why	3.8±0.9	4.4±1.0	0.272	0.321	0.7±0.3	0.004
BFQ total score	65.6±9.0	63.7±8.1	0.779	0.017	9.8±4.2	< 0.001

Table: Table 1: Comparison of brain fog questionnaire responses in patients (baseline vs week 2), and healthy volunteers.

Disclosures:

Asad Jehangir indicated no relevant financial relationships.

Eula Tetangco indicated no relevant financial relationships.

Adil Ghafoor indicated no relevant financial relationships.

Yun Yan indicated no relevant financial relationships.

Amanda Laufer indicated no relevant financial relationships.

Tennakoon Karunaratne indicated no relevant financial relationships.

Brooke Inman indicated no relevant financial relationships.

Amol Sharma indicated no relevant financial relationships.

Satish Rao: Salix Pharmaceuticals – Grant/Research Support. Vibrant – Advisor or Review Panel Member. Vibrant – Clinical Advisory Board.

Asad Jehangir, MD¹, Eula P. Tetangco, MD, MPH², Adil Ghafoor, MD³, Yun Yan, PhD⁴, Amanda Laufer, PA-C⁴, Tennakoon Karunaratne, MD⁴, Brooke Inman, BSc³, Amol Sharma, MD⁴, Satish Rao, MD⁴. A0250 - Development and Validation of Brain Fog Questionnaire in Patients and Healthy Volunteers, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.