{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:50:43Z","timestamp":1791535843806,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this scoping review was to synthesize evidence on the proportion of individuals living with Sj\u00f6gren's disease who experience central nervous system (CNS) manifestations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE (via PubMed) and Embase from 1980 through January 29, 2026, and the ECRI Guidelines Trust from 2020 through January 29, 2026. Title and abstract screening, followed by full\u2010text review, were performed in duplicate using prespecified inclusion and exclusion criteria. One reviewer extracted data, with an independent audit completed by one of the project coleads. Meta\u2010analyses of proportions were conducted. Sensitivity analyses were planned a priori to evaluate the influence of statistical outliers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 22,857 citations, of which 108 met the inclusion criteria. Pooled proportion estimates were generated for 23 CNS manifestations. Several manifestations occurred at frequencies exceeding those reported in the general population, including depression, migraine, insomnia, cognitive dysfunction, psychosis, movement disorders, aseptic meningoencephalitis, neuromyelitis optica spectrum disorder, optic neuritis, multiple sclerosis, cerebral vasculitis, cerebellar syndrome, spinal cord involvement, and non\u2010localizing somatosensory complaints. The degree of increased frequency differed substantially across manifestations, and several estimates were highly influenced by individual studies, as indicated by sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The spectrum of CNS involvement in Sj\u00f6gren's disease is broad and heterogeneous. Attributing CNS manifestations to direct Sj\u00f6gren's disease involvement or coexisting conditions remains unclear and cannot be assumed to be causally linked. Our findings underscore the complexity of CNS manifestations in Sj\u00f6gren's disease and highlight the need for evidence\u2010informed guidance to support accurate diagnosis, attribution, and management of neurologic manifestations.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80166-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80166","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:08:18Z","timestamp":1789988898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Scoping Review and Meta\u2010Analysis of Proportions of Central Nervous System Manifestations Reported in Patients with Sj\u00f6gren's Disease"],"prefix":"10.1002","author":[{"given":"Arun","family":"Varadhachary","sequence":"first","affiliation":[{"name":"Washington University School of Medicine  St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghaith","family":"Noaiseh","sequence":"additional","affiliation":[{"name":"University of Kansas  Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Frantsve\u2010Hawley","sequence":"additional","affiliation":[{"name":"Sj\u00f6gren's Foundation  Reston Virginia"},{"name":"AT Still University College of Graduate Health Studies  Kirksville Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick B.","family":"Vivino","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-5090","authenticated-orcid":false,"given":"Jennifer A.","family":"McCombe","sequence":"additional","affiliation":[{"name":"University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamik","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Sherwood","family":"Brown","sequence":"additional","affiliation":[{"name":"The University of Texas Southwestern Medical Center  Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Carey","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute, Johns Hopkins University School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Fox","sequence":"additional","affiliation":[{"name":"Scripps Memorial Hospital and Research Foundation  La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Grader\u2010Beck","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"University of Virginia Medical Center  Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Maitz","sequence":"additional","affiliation":[{"name":"US Department of Veterans Affairs  Coatesville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Mandel","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-2948","authenticated-orcid":false,"given":"Astrid","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Sarka","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center  Los Angeles California"},{"name":"California State University  Northridge"},{"name":"MemorialCare Saddleback Medical Center  Laguna Hills California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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