Glanz B I, Holland C M, Gauthier S A, Amunwa E L, Liptak Z, Houtchens M K, Sperling R A, Khoury S J, Guttmann C R G, Weiner H L
Department of Neurology, Brigam and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Mult Scler. 2007 Sep;13(8):1004-10. doi: 10.1177/1352458507077943. Epub 2007 Jul 10.
Cognitive dysfunction is common in patients with multiple sclerosis (MS), and has been associated with MRI measures of lesion burden and atrophy. Little is known about the prevalence of cognitive impairment in patients with early MS. The associations between cognitive impairment and MRI measures of disease severity early in the disease course are also unclear. This study used a brief battery of cognitive tests to determine the prevalence and pattern of cognitive impairment in patients with clinically isolated syndromes or newly diagnosed MS. The associations between cognitive impairment and MRI measures of disease severity early in the disease course were also examined. Ninety-two patients with clinically isolated syndromes or the diagnosis of MS within the last 3 years participating in the CLIMB study underwent a neurologic examination, neuropsychological evaluation and MRI at 1.5 T. Forty-nine percent of patients were impaired on one or more cognitive measures. There were no significant correlations between cognitive scores and MRI measures of disease severity including total T2 lesion volume, normal appearing white matter volume, grey matter volume, and brain parenchymal fraction. These findings suggest that cognitive impairment may predate the appearance of gross structural abnormalities on MRI and serve as an early marker of disease activity in MS.
认知功能障碍在多发性硬化症（MS）患者中很常见，并且与病变负荷和萎缩的MRI测量值相关。对于早期MS患者认知障碍的患病率知之甚少。疾病进程早期认知障碍与疾病严重程度的MRI测量值之间的关联也不清楚。本研究使用一组简短的认知测试来确定临床孤立综合征或新诊断的MS患者认知障碍的患病率和模式。还研究了疾病进程早期认知障碍与疾病严重程度的MRI测量值之间的关联。参与CLIMB研究的92例临床孤立综合征患者或在过去3年内诊断为MS的患者接受了神经系统检查、神经心理评估和1.5T的MRI检查。49%的患者在一项或多项认知测量中受损。认知评分与疾病严重程度的MRI测量值之间无显著相关性，包括总T2病变体积、正常外观白质体积、灰质体积和脑实质分数。这些发现表明，认知障碍可能早于MRI上明显结构异常的出现，并可作为MS疾病活动的早期标志物。
