Sánchez M P, Nieto A, Barroso J, Martín V, Hernández M A
Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, University of La Laguna, Canary Islands, Spain.
Eur J Neurol. 2008 Oct;15(10):1091-9. doi: 10.1111/j.1468-1331.2008.02259.x. Epub 2008 Aug 25.
We have studied the relationship between neuropsychological impairment and magnetic resonance imaging (MRI) measures in mildly disabling relapsing-remitting multiple sclerosis (RRMS).
We compared measures of lesion burden and atrophy in 52 patients with Expanded Disability Status Scale <or= 3.0. Neuropsychological testing explored various cognitive domains: attention and processing speed (APS), verbal and visual memory (VerbM; VisM), visual/constructional processes (VC), executive functions and motor programming/coordination. Specific and global index scores were derived to classify patients as deteriorated or not deteriorated by comparing their performance with 51 matched normal control subjects. Brain MRI analysis included proton density (PD)-lesion volume and T1-hypointensity volume, measures of central atrophy, including the third ventricle width, and corpus callosum (CC).
Patients with either APS, MCP or Verbal Learning impairments had a higher ventricular atrophy than unimpaired. The atrophy of the CC was only associated to VisM dysfunction. Patients with VisM deficits had higher lesion load on PD images. After controlling for age and education a higher third ventricle width was the best predictor for global and specific cognitive impairment.
Our results suggest that cognitive impairment in RR patients with mild disease is better explained by atrophic changes than by total lesion load.
我们研究了轻度致残性复发缓解型多发性硬化症（RRMS）患者的神经心理学损伤与磁共振成像（MRI）测量指标之间的关系。
我们比较了52例扩展残疾状态量表评分≤3.0的患者的病灶负荷和萎缩测量指标。神经心理学测试探索了多个认知领域：注意力和处理速度（APS）、言语和视觉记忆（VerbM；VisM）、视觉/构建过程（VC）、执行功能以及运动编程/协调能力。通过将患者的表现与51名匹配的正常对照受试者进行比较，得出特定和总体指数评分，以将患者分类为病情恶化或未恶化。脑MRI分析包括质子密度（PD）病灶体积和T1低信号体积、中央萎缩测量指标，包括第三脑室宽度和胼胝体（CC）。
存在APS、运动编程/协调能力或言语学习损伤的患者比未受损患者有更高的脑室萎缩。胼胝体萎缩仅与视觉记忆功能障碍相关。存在视觉记忆缺陷的患者在PD图像上有更高的病灶负荷。在控制年龄和教育程度后，较高的第三脑室宽度是总体和特定认知损伤的最佳预测指标。
我们的结果表明，轻度疾病的RR患者的认知损伤用萎缩性变化比用总病灶负荷能更好地解释。
