Lincoln N B, Dent A, Harding J, Weyman N, Nicholl C, Blumhardt L D, Playford E D
School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK.
J Neurol Neurosurg Psychiatry. 2002 Jan;72(1):93-8. doi: 10.1136/jnnp.72.1.93.
Cognitive problems in multiple sclerosis are common but any possible benefits of treatment remain uncertain. The aim of the study was to evaluate the benefits of providing a psychology service, including cognitive assessment and intervention, to patients with multiple sclerosis.
The study was a single blind randomised controlled trial. A total of 240 patients with clinically definite, laboratory supported, or clinically probable multiple sclerosis were recruited from an multiple sclerosis management clinic and assessed on a brief screening battery. They were randomised into three groups. The control group received no further intervention. The assessment group received a detailed cognitive assessment, the result of which was fed back to staff involved in the patients' care. The treatment group received the same detailed cognitive assessment and a treatment programme designed to help reduce the impact of their cognitive problems. Patients were followed up 4 and 8 months later on the general health questionnaire (GHQ-28), extended activities of daily living scale, SF-36, everyday memory questionnaire, dysexecutive syndrome questionnaire, and memory aids questionnaire.
The three groups were compared on the outcome measures at 4 and 8 months after recruitment. There were few significant differences between the groups and those that occurred favoured the control group. Overall, the results showed no effect of the interventions on mood, quality of life, subjective cognitive impairment or independence.
The study failed to detect any significant effects of cognitive assessment or cognitive intervention in this cohort of people with multiple sclerosis.
多发性硬化症患者中认知问题很常见,但治疗的任何潜在益处仍不明确。本研究的目的是评估为多发性硬化症患者提供心理服务(包括认知评估和干预)的益处。
该研究为单盲随机对照试验。从一家多发性硬化症管理诊所招募了总共240例临床确诊、实验室支持或临床疑似多发性硬化症的患者,并通过简短筛查量表进行评估。他们被随机分为三组。对照组未接受进一步干预。评估组接受了详细的认知评估,评估结果反馈给参与患者护理的工作人员。治疗组接受了相同的详细认知评估以及旨在帮助减轻其认知问题影响的治疗方案。在4个月和8个月后,对患者进行随访,使用一般健康问卷(GHQ - 28)、日常生活活动扩展量表、SF - 36、日常记忆问卷、执行功能障碍综合征问卷和记忆辅助问卷。
在招募后的4个月和8个月,对三组患者的结局指标进行比较。各组之间几乎没有显著差异,且出现的差异有利于对照组。总体而言,结果显示干预对情绪、生活质量、主观认知障碍或独立性没有影响。
该研究未能在这组多发性硬化症患者中检测到认知评估或认知干预的任何显著效果。