Andreu-Català M, Pascual-Lozano A M, Bueno-Cayo A, Boscá-Blasco I, Coret-Ferrer F, Casanova-Estruch B
Servicio de Neuropsicología, Hospital La Fe, 46009 Valencia, Espana.
Rev Neurol. 2008;46(11):664-6.
To define the patterns of cognitive impairment in a homogeneous group of secondary progressive multiple sclerosis (SPMS) patients.
Forty-two SPMS patients were included with a similar degree of disability; all had been treated with interferon beta-1b for a minimum of 3 months. They voluntarily complimented a battery of 10 neuropsychological tests selected for this study, distributed in two sessions of one hour. In addition, the emotional state was evaluated with the Beck Depression Inventory and the Hamilton Anxiety Scale. We considered cognitive impairment as more than two tests altered, according with previously reported studies.
73.8% of patients were women; mean age was 45 years (range: 25-62); mean EDSS was 5.4 (range: 3.0-7.5); mean evolution time was 34.5 months (range: 24-80); mean treatment duration was 13.5 months (range: 3-38). Cognitive impairment was present in 78.5% of patients. The most frequently impaired functions were: attentional capacity, visuospatial perception, verbal fluency, short-term and long-term logic memory and abstract reasoning. The presence of cognitive impairment was related to the time of evolution of the disease (r = 0.31; p < 0.05) but not with the age, the degree of disability or the treatment duration.
Cognitive impairment in the SPMS patients is a frequent finding, being the alteration in the speed for the acquisition and processing of new information, and the abstract reasoning the most frequent and severe altered functions. The also frequent impairment of visuospatial information was a differential finding in our study that could contribute to diagnosis of clinical progression.
明确一组病情均一的继发进展型多发性硬化（SPMS）患者的认知障碍模式。
纳入42例残疾程度相似的SPMS患者；所有患者均接受了至少3个月的β-1b干扰素治疗。他们自愿完成了为本研究选择的一组10项神经心理学测试，分两个时段进行，每个时段1小时。此外，使用贝克抑郁量表和汉密尔顿焦虑量表评估情绪状态。根据先前报道的研究，我们将两项以上测试结果异常视为认知障碍。
73.8%的患者为女性；平均年龄45岁（范围：25 - 62岁）；平均扩展残疾状态量表（EDSS）评分为5.4（范围：3.0 - 7.5）；平均病程为34.5个月（范围：24 - 80个月）；平均治疗时长为13.5个月（范围：3 - 38个月）。78.5%的患者存在认知障碍。最常受损的功能为：注意力、视觉空间感知、语言流畅性、短期和长期逻辑记忆以及抽象推理。认知障碍的存在与疾病病程相关（r = 0.31；p < 0.05），但与年龄、残疾程度或治疗时长无关。
SPMS患者中认知障碍很常见，获取和处理新信息的速度改变以及抽象推理是最常见且最严重受损的功能。视觉空间信息的频繁受损也是本研究中的一个不同发现，可能有助于临床进展的诊断。
