Fulton J C, Grossman R I, Udupa J, Mannon L J, Grossman M, Wei L, Polansky M, Kolson D L
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
AJNR Am J Neuroradiol. 1999 Nov-Dec;20(10):1951-5.
Multiple sclerosis (MS) is a demyelinating disease most often associated with progressive physical impairment; however, its effects are noted to extend beyond physical disability. Our purpose was to determine the relationship between T2 lesion volume and neurocognitive and physical disability in relapsing-remitting multiple sclerosis.
We studied a cohort of 19 patients with relapsing-remitting MS. Of this group, there were 15 women and four men from varying socioeconomic backgrounds. This volunteer sample was selected from a larger group of 53 patients with MS in our longitudinal MS study because they had been untreated with any beta-interferon medications, had been followed for at least 12 months, and had a clinical status of relapsing-remitting MS.
Of 12 neurocognitive parameters tested, two correlated significantly with lesion loads. The correlation of the Symbol-Digit Modalities test, which analyzes information-processing speed, was significant (P = .0204). The correlation of the fifth trial of the Rey Auditory Verbal Learning test, which tests verbal long-term memory, was also significant (P = .0348). None of the other 10 neurocognitive examinations, however, showed a significant correlation with total lesion volume (Paced Auditory Serial Addition test-1.6, P = .7381; Paced Auditory Serial Addition test-2.0, P = .4180; Controlled Oral Word Association test, P = .8906; Category Fluency test, P = .4423; Bells test, P = .9097; Rey Auditory Verbal Learning test-delay, P = .9843, Rey Auditory Verbal Learning test-recognition, P = .7467; Word Span test, P = .4939; Road Map test, P = 0.4939). The lesion load also did not correlate with the physical disability scales as rated according to the Expanded Disability Status Scale (P = .68) or Ambulation Index (P = .95).
Our results indicate that T2 lesion volume does not seem to be a robust surrogate marker of neuropsychological impairment in patients with MS. We think that global measurements of parameters that are more specific to the disease process may offer more precise correlation with cognitive dysfunction and other disability parameters.
多发性硬化症（MS）是一种脱髓鞘疾病，最常与进行性身体损伤相关；然而，其影响不仅限于身体残疾。我们的目的是确定复发缓解型多发性硬化症中T2病变体积与神经认知及身体残疾之间的关系。
我们研究了一组19例复发缓解型MS患者。该组中有15名女性和4名男性，来自不同社会经济背景。这个志愿者样本是从我们纵向MS研究中53例MS患者的更大群体中挑选出来的，因为他们未接受过任何β-干扰素药物治疗，已随访至少12个月，且临床状态为复发缓解型MS。
在测试的12项神经认知参数中，两项与病变负荷显著相关。分析信息处理速度的符号数字模式测试的相关性显著（P = 0.0204）。测试言语长期记忆的雷伊听觉词语学习测试第五次试验的相关性也显著（P = 0.0348）。然而，其他10项神经认知检查中，没有一项与总病变体积显示出显著相关性（定速听觉连续加法测试-1.6，P = 0.7381；定速听觉连续加法测试-2.0，P = 0.4180；受控口语词联想测试，P = 0.8906；类别流畅性测试，P = 0.4423；铃声测试，P = 0.9097；雷伊听觉词语学习测试-延迟，P = 0.9843，雷伊听觉词语学习测试-识别，P = 0.7467；词语广度测试，P = 0.4939；路线图测试，P = 0.4939）。病变负荷也与根据扩展残疾状态量表评定的身体残疾量表（P = 0.68）或步行指数（P = 0.95）无关。
我们的结果表明，T2病变体积似乎不是MS患者神经心理损伤的可靠替代标志物。我们认为，对更具疾病特异性的参数进行整体测量可能与认知功能障碍和其他残疾参数具有更精确的相关性。
