{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:26Z","timestamp":1790660786855,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Rheumatoid arthritis (RA) has been associated with accelerated atherosclerosis and cerebrovascular alterations. Our 2017 study compared 60 RA patients to healthy controls, assessing vascular, neurological, and cognitive parameters. The present study is a follow-up of these RA patients to evaluate disease progression and vascular changes over time, using their 2017 results as baseline. Methods: In 2023, we reassessed 43 of the original 60 RA patients using laboratory testing, carotid ultrasound, functional transcranial Doppler (TCD) and brain magnetic resonance imaging (MRI) examinations. Changes over time were analyzed within the same individuals. Results: Inflammatory markers and lipid profiles showed a trend toward improvement, though changes were not statistically significant, except for a significant increase in vitamin D (p &lt; 0.001) and a decrease in Disease Activity Score in 28 Joints (DAS28) scores (p &lt; 0.001). Carotid ultrasound revealed a significant increase in plaque burden (p = 0.022 on the right side and p = 0.008 on the left), while carotid intima media thickness (cIMT) showed a non-significant rise. TCD measurements indicated significantly increased pulsatility (p &lt; 0.001 on the right, p = 0.001 on the left side) and resistance (p = 0.001 on the right, p = 0.012 on the left side) indices and reduced flow velocities (p &lt; 0.001 on the right and p = 0.001 on the left side) in bilateral middle cerebral arteries (MCAs). The cerebrovascular reserve capacity was significantly lower on the right side overall (p = 0.013), with further decline noted in the methotrexate (MTX)-treated subgroup on the left side (p = 0.043). MRI findings showed non-significant numerical trends toward worsening lacunar small-vessel disease (p = 0.405) and cerebral atrophy (p = 0.063), with higher but stable lacunar infarction scores among MTX users (p = 0.023). Conclusions: Despite improved inflammatory control, RA patients demonstrated progressive vascular and hemodynamic alterations over time, while MRI changes should be interpreted as trends. These findings support multimodal vascular monitoring in RA.<\/jats:p>","DOI":"10.3390\/jcm15124691","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:22:56Z","timestamp":1781684576000},"page":"4691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Follow-Up Study of the Supraaortic and Intracranial Vessels, Cerebrovascular Reactivity, Brain Vascular Lesions and Atrophy in Patients with Rheumatoid Arthritis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0293-9803","authenticated-orcid":false,"given":"Attila","family":"Sas","sequence":"first","affiliation":[{"name":"Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Department of Stroke-Neurology-Toxicology, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e1vid","family":"J\u00f3nyer","sequence":"additional","affiliation":[{"name":"Department of Stroke-Neurology-Toxicology, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Valikovics","sequence":"additional","affiliation":[{"name":"Department of Stroke-Neurology-Toxicology, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"},{"name":"Faculty of Health Sciences, University of Miskolc, 3515 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-3040","authenticated-orcid":false,"given":"L\u00e1szl\u00f3","family":"Kosty\u00e1l","sequence":"additional","affiliation":[{"name":"Department of Radiology, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Institute of Nursing Science and Diagnostic Imaging, University of Miskolc, 3515 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9422-0541","authenticated-orcid":false,"given":"Zsuzsanna","family":"Ol\u00e1h","sequence":"additional","affiliation":[{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Institute of Nursing Science and Diagnostic Imaging, University of Miskolc, 3515 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Hodosi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zs\u00f3fia","family":"Kardos","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Miskolc, 3515 Miskolc, Hungary"},{"name":"Department of Rheumatology, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-9322","authenticated-orcid":false,"given":"Csaba","family":"Ol\u00e1h","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"},{"name":"Mathias Institute, University of Tokaj, 3950 Sarospatak, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7794-6844","authenticated-orcid":false,"given":"Zolt\u00e1n","family":"Szekanecz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1053\/berh.2002.0257","article-title":"Epidemiology of rheumatoid arthritis: Determinants of onset, persistence and outcome","volume":"16","author":"Symmons","year":"2002","journal-title":"Best Pract. 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