Portaccio Emilio, Amato Maria Pia, Bartolozzi Maria Letizia, Zipoli Valentina, Mortilla Marzia, Guidi Leonello, Siracusa Gianfranco, Sorbi Sandro, Federico Antonio, De Stefano Nicola
Department of Neurology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
J Neurol Sci. 2006 Jun 15;245(1-2):195-9. doi: 10.1016/j.jns.2005.07.019. Epub 2006 Apr 24.
The aim of the study was to assess neocortical changes and their relevance to cognitive impairment in early relapsing-remitting multiple sclerosis (RRMS). Conventional magnetic resonance was acquired in 41 RRMS patients and 16 demographically matched normal controls (NC). An automated analysis tool was used to obtain measures of cortical brain volumes normalized for head size. Neuropsychological performance of MS patients was assessed through the Rao's Brief Repeatable Battery. We identified 18 cognitively preserved (MS-cp) and 23 cognitively impaired (MS-ci) MS patients. Values of normalized cortical volumes (NCV) in the whole MS sample were lower than those in the NC group (p=0.01). MS-ci patients showed NCV values lower (p=0.02) than did both MS-cp patients and NC. Moreover, we found a positive correlation between NCV values and measures of verbal memory (r=0.51, p=0.02), verbal fluency (r=0.51, p=0.01) and attention/concentration (r=0.65, p<0.001) in MS-ci patients. Furthermore, NCV values were significantly decreased in patients who scored lower on a greater number of tests (r=-0.58, p<0.01) in the MS-ci group. Only MS-ci patients had cortical atrophy significantly correlated with a poorer neuropsychological performance. Grey matter pathology may contribute to the development of cognitive impairment in MS from the earliest stages of the disease.
该研究的目的是评估早期复发缓解型多发性硬化症（RRMS）患者的新皮质变化及其与认知障碍的相关性。对41例RRMS患者和16例人口统计学匹配的正常对照者（NC）进行了传统磁共振检查。使用自动化分析工具获得针对头部大小进行标准化的皮质脑容量测量值。通过Rao简短可重复成套测验评估MS患者的神经心理学表现。我们确定了18例认知功能保留的（MS-cp）和23例认知功能受损的（MS-ci）MS患者。整个MS样本的标准化皮质体积（NCV）值低于NC组（p=0.01）。MS-ci患者的NCV值低于MS-cp患者和NC组（p=0.02）。此外，我们发现MS-ci患者的NCV值与言语记忆测量值（r=0.51，p=0.02）、言语流畅性（r=0.51，p=0.01）和注意力/专注力（r=0.65，p<0.001）之间存在正相关。此外，在MS-ci组中，在更多测试中得分较低的患者的NCV值显著降低（r=-0.58，p<0.01）。只有MS-ci患者的皮质萎缩与较差的神经心理学表现显著相关。灰质病理学可能在MS疾病的最早阶段就对认知障碍的发展起作用。
