Archibald Catherine J, Wei Xingchang, Scott James N, Wallace Carla J, Zhang Yunyan, Metz Luanne M, Mitchell J Ross
Seaman Family MR Research Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta Canada T2N 2T9.
Brain. 2004 Jul;127(Pt 7):1526-34. doi: 10.1093/brain/awh167. Epub 2004 Apr 16.
The relationship between performance on information processing efficiency measures and MRI-derived lesion volume including global and regional T2 and T1 lesion volumes was investigated in 20 patients with relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Processing speed, as measured by the Sternberg Memory Scanning Test, was significantly correlated with posterior fossa lesion volume and slowed reaction time in seven out of eight patients (six out of seven with SPMS) with any lesion volume in the posterior fossa suggesting a 'threshold effect'. Processing capacity as measured by the Salthouse Keeping Track Test was not significantly correlated with the MRI measures. Cognitive performance did not correlate with Expanded Disability Status Scale score, depression or fatigue, and patients performed within normal limits on tests of attention/concentration ability. The significant relationship between posterior fossa lesion volume and memory scanning speed in this study suggests that pathological damage in the posterior fossa may contribute to slowed cognitive processing and may be an important direction for future studies of cognitive function in multiple sclerosis. Lack of correlation of cognitive measures with the other MRI measures may be due to low lesion volume relative to other studies, sample composition, and limited pathological specificity of the MRI measures.
在20例复发缓解型多发性硬化(RRMS)和继发进展型多发性硬化(SPMS)患者中,研究了信息处理效率指标表现与MRI衍生的病灶体积之间的关系,包括整体及局部T2和T1病灶体积。通过斯特恩伯格记忆扫描测试测得的处理速度,与后颅窝病灶体积显著相关,并且在八名后颅窝有任何病灶体积的患者中有七名(七名SPMS患者中有六名)反应时间减慢,提示存在“阈值效应”。通过索尔特豪斯追踪测试测得的处理能力与MRI指标无显著相关性。认知表现与扩展残疾状态量表评分、抑郁或疲劳均无相关性,并且患者在注意力/集中能力测试中的表现处于正常范围内。本研究中后颅窝病灶体积与记忆扫描速度之间的显著关系表明,后颅窝的病理损伤可能导致认知处理速度减慢,并且可能是未来多发性硬化认知功能研究的一个重要方向。认知指标与其他MRI指标缺乏相关性,可能是由于相对于其他研究而言病灶体积较小、样本构成以及MRI指标的病理特异性有限。