Millefiorini E, Padovani A, Pozzilli C, Loriedo C, Bastianello S, Buttinelli C, Di Piero V, Fieschi C
Department of Neurological Science, University of Rome La Sapienza, Italy.
Acta Neurol Scand. 1992 Oct;86(4):354-8. doi: 10.1111/j.1600-0404.1992.tb05100.x.
This study investigated the relationship between depression, physical disability, cognitive deficit and brain abnormalities on magnetic resonance imaging (MRI) in patients with early MS. Eighteen relapsing-remitting MS patients were evaluated: depression was diagnosed according to DSM-III R and measured by the MMPI depression subscale, physical disability was assessed by using the Kurtzke Expanded Disability Status Scale (EDSS) and cognitive functions by means of an extensive neuropsychological test battery. A neuroradiologist blinded to clinical findings quantified cerebral lesion on MRI. Weighted brain area lesion score were developed according to number and size of cerebral lesions. On the basis of DSM-III criteria, six patients were classified as having major depression, seven patients had minor depression and five patients were without depressive symptoms. No significant differences were found among the three groups on both neuropsychological performances and weighted MRI lesion scores. However patients with major depression exhibit greater physical disability than the other MS subgroups. A significant correlation was found between MMPI depression subscale and physical disability. This study suggests that at least in the early phase of MS, depression appears more related to the physical disability than to the severity of pathological brain involvement.
本研究调查了早期多发性硬化症（MS）患者中抑郁、身体残疾、认知缺陷与磁共振成像（MRI）显示的脑异常之间的关系。对18例复发缓解型MS患者进行了评估：根据《精神疾病诊断与统计手册》第三版修订版（DSM-III R）诊断抑郁，并通过明尼苏达多相人格调查表（MMPI）抑郁分量表进行测量，使用库茨克扩展残疾状态量表（EDSS）评估身体残疾情况，并通过一套广泛的神经心理测试组合来评估认知功能。一名对临床结果不知情的神经放射科医生对MRI上的脑损伤进行量化。根据脑损伤的数量和大小制定加权脑区损伤评分。根据DSM-III标准，6例患者被归类为重度抑郁，7例患者为轻度抑郁，5例患者无抑郁症状。三组在神经心理表现和加权MRI损伤评分方面均未发现显著差异。然而，重度抑郁患者比其他MS亚组表现出更大的身体残疾。MMPI抑郁分量表与身体残疾之间存在显著相关性。本研究表明，至少在MS的早期阶段，抑郁似乎与身体残疾的关系比与病理性脑受累的严重程度更为密切。
