Lanzillo Roberta, Prinster Anna, Scarano Valentina, Liuzzi Raffaele, Coppola Giovanni, Florio Ciro, Salvatore Elena, Schiavone Vittorio, Brunetti Arturo, Muto Mario, Orefice Giuseppe, Alfano Bruno, Bonavita Vincenzo, Brescia Morra Vincenzo
Department of Neurological Sciences, Federico II University, Via Pansini, 5 80131 Naples, Italy.
J Neurol Sci. 2006 Jun 15;245(1-2):141-5. doi: 10.1016/j.jns.2005.08.023. Epub 2006 Apr 19.
Few trials issued the effect of disease-modifying medications on cognitive functions in multiple sclerosis. We designed an open-label longitudinal study to evaluate, during 2 years, cognitive performance and its relationship with MRI data and ApoE polymorphism findings in a group of relapsing-remitting (RR) multiple sclerosis (MS) Interferon (IFN) beta-1b-treated patients (median age 30 years, median disease duration 3.4 years). Complete neuropsychological battery was grouped into attention, information learning/memory, language and visuo-spatial functions. Fifty-two patients (33 females) were enrolled in the study. Six patients (11.5%) dropped out, mainly due to side effects. At baseline neuropsychological evaluation, we found 54% normal, 42% mildly impaired and 4% moderately impaired patients. At 2 years follow-up, cognitive status was stable in 65%, improved in 33% and worsened in 2% of patients. No significant relations were found between global cognitive outcome vs. EDSS change, clinical disease activity, MRI data or ApoE gene polymorphisms over the 2 years follow-up. EDSS and MRI fractional volumes were found to correlate with the performance at single tests. Twenty-one patients (45.6%) showed active MRI scans throughout the study, without any worsening at the corresponding neuropsychological examination. This ongoing trial suggests a possible beneficial effect of IFN beta-1b treatment on cognitive functions in RRMS patients. Extension of follow-up and further data analyses are needed to confirm and clarify these findings.
很少有试验研究疾病修饰药物对多发性硬化症认知功能的影响。我们设计了一项开放标签纵向研究,以评估一组复发缓解型(RR)多发性硬化症(MS)患者在接受干扰素(IFN)β-1b治疗期间(为期2年)的认知表现及其与MRI数据和载脂蛋白E(ApoE)基因多态性结果的关系(中位年龄30岁,中位病程3.4年)。完整的神经心理测试组合分为注意力、信息学习/记忆、语言和视觉空间功能。52名患者(33名女性)参与了该研究。6名患者(11.5%)退出,主要原因是副作用。在基线神经心理评估中,我们发现54%的患者正常,42%的患者轻度受损,4%的患者中度受损。在2年的随访中,65%的患者认知状态稳定,33%的患者认知状态改善,2%的患者认知状态恶化。在2年的随访中,未发现整体认知结果与扩展残疾状态量表(EDSS)变化、临床疾病活动、MRI数据或ApoE基因多态性之间存在显著关系。发现EDSS和MRI分数体积与单项测试的表现相关。21名患者(45.6%)在整个研究过程中MRI扫描显示有活动,但相应的神经心理检查没有任何恶化。这项正在进行的试验表明,IFNβ-1b治疗可能对RRMS患者的认知功能有有益影响。需要延长随访时间并进行进一步的数据分析来证实和阐明这些发现。