Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings

It is correct in science to believe that it is only “true” if we can verifiably measure it … though we should avoid the arrogance that we are capable of measuring all the variables that form the molecular basis of pain or behavior, namely, the “software” of the brain.

SS sits at the interface of neurology, immunology and behavioral science. These patients can be defined at least phenotypically as counterparts and represent a good starting point for the next decade of imaginative research.

Robert I. Fox, MD, PhD, is chief of the Rheumatology Clinic at Scripps Memorial Hospital–Ximed in La Jolla, Calif.

Carla M. Fox, RN, is a registered nurse in the clinic at Scripps Memorial Hospital–Ximed.

References

1. Bloch KJ, Buchanan WW, Wohl MJ, et al. Sjögren’s syndrome: A clinical, pathological and serological study of 62 cases. Medicine (Baltimore). 1956;44:187–231.
2. Mekinian A, Ravaud P, Hatron P, et al. Efficacy of rituximab in primary Sjögren’s syndrome with peripheral nervous system involvement: Results from the AIR registry. Ann Rheum Dis. 2012 Jan;71(1):84–87.
3. St. Clair EW, Levesque MC, Prak ET, et al. Rituximab therapy for primary Sjögren’s syndrome: An open-label clinical trial and mechanistic analysis. Arthritis Rheum. 2013 Apr;65(4):1097–1106.
4. Devauchelle-Pensec V, Mariette X, Jousse-Joulin S, et al. Treatment of primary Sjögren syndrome with rituximab: A randomized trial. Ann Intern Med. 2014 Feb 18;160(4):233–242.
5. Ramachandran VS, Blakeslee S, Sacks OW. Phantoms in the Brain: Probing the Mysteries of the Human Mind. New York: William Morrow, 1998.
6. Ramachandran VS. Filling in gaps in perception: Part II. Scotomas and phantom limbs. Curr Dir Psychol Sci. 1993 Apr;2:56–65.
7. Ramachandran VS, Rogers-Ramachandran D. Phantom limbs and neural plasticity. Arch Neurol. 2000 Mar;57(3):317–320.
8. Armel KC, Ramachandran VS. Projecting sensations to external objects: Evidence from skin conductance response. Proc Biol Sci. 2003 Jul 22; 270(1523):1499–1506.
9. Matzinger P. Tolerance, danger, and the extended family. Annu Rev Immunol. 1994;12:991–1045.