Ankylosing spondylitis (AS) is a form of inflammatory arthritis that primarily affects the spine. Although people often think about the physical symptoms, living with AS can also lead to what is known as brain fog.
Brain fog is not a medical condition. Instead, it is a phrase that people often use to describe symptoms related to thinking processes, recalling information, problem-solving, concentrating, or learning new things.
These symptoms are a common feature in chronic inflammatory conditions, such as AS, rheumatoid arthritis (RA), multiple sclerosis (MS), and other conditions.
A person can take steps to address brain fog, such as adopting preventive measures and following their AS treatment care plan.
People who are experiencing impairments in their memory, attention, or other cognitive skills may describe these symptoms conversationally as brain fog. Healthcare professionals may use more clinical terms, such as cognitive dysfunction or cognitive impairment, when referring to some of the same symptoms.
According to experts, cognitive dysfunction
- auditory processing
- verbal and nonverbal learning
- short-term and working memory
- motor functioning
- visual processing
- processing speed
- making decisions
- learning new things
How AS affects the brain and central nervous system is still not clear. According to a 2020 study, researchers still do not know the prevalence of cognitive dysfunction among people with AS. They also suggest that it may be underreported.
Experts do not yet fully understand how conditions such as AS cause brain fog to occur. However, they do believe that brain fog may have a link to the chronic inflammation and pain associated with the condition.
Factors that may cause brain fog in people with AS may include the following:
Conditions such as AS involve the immune system mistakenly attacking healthy cells in the body. When it does, it releases proteins known as cytokines, which cause inflammation to occur. Active cytokines send signals to a person’s brain, which may interfere with its expected functioning.
Pain associated with AS can lead to a combination of fatigue and impaired cognitive ability.
The Spondylitis Association of America points out that the symptoms of AS can make it difficult for a person to sleep, leading to increased pain, stiffness, and fatigue, which then affect sleep further. This can lead to a cycle of sleeplessness and more severe symptoms.
Other experts note that chronic pain can cause the nervous system to become extra sensitive, which makes sleeping more difficult. The resulting fatigue can contribute to brain fog.
Use of corticosteroids
Doctors also use corticosteroids as a localized treatment for AS, which could indicate that people with AS and cardiovascular risk factors also have an increased risk of brain fog associated with steroid use.
AS is not the only possible cause of brain fog. Several other health conditions and factors can contribute to brain fog,
- chronic fatigue syndrome (CFS)
- thyroid issues
- lack of sleep
- lack of exercise
People with AS who experience brain fog can take steps to help reduce its effects. The treatment for brain fog typically involves treating the underlying AS and making lifestyle adjustments that can help improve brain functioning.
Some tips and strategies to help reduce brain fog
- focusing on the organization of thoughts, events, and so on to help keep a person alert throughout the day
- using treatments for AS, including biologics, disease-modifying antirheumatic drugs (DMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs), and other therapies
- adopting good sleep hygiene practices
- engaging in psychological therapies
- exercising regularly
In addition, a person may find it helpful to take additional steps, such as:
- recording when they experience brain fog to help look for patterns that they may be able to address
- taking a deep breath and trying to relax when a cognitive issue is causing them frustration
- practicing mindfulness, yoga, or other therapies to help relaxation
- talking about medication options with a doctor
- removing sources of light from the bedroom and making it cooler to promote sleep
- keeping a consistent sleep schedule
People who continue to experience brain fog should talk with a doctor who may be able to make additional recommendations. The doctor might adjust the person’s prescription if they suspect that a current medication is not enough to control the symptoms or may be the cause of the brain fog.
AS can cause a person to experience problems with memory, thinking, concentrating, and other cognitive dysfunctions that people typically refer to as brain fog. The exact reasons for brain fog are not clear, but experts believe that chronic inflammation, pain, and some treatment side effects can all contribute. Depression may also play a role.
A person with AS can take several steps to reduce their brain fog. These include treating the underlying condition and making certain lifestyle changes, such as getting more sleep and exercising regularly.