Brissart H, Leroy M, Debouverie M
Service de Neurologie, Hôpital Central, CHU de Nancy, Avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy Cedex, France.
Rev Neurol (Paris). 2010 Apr;166(4):406-11. doi: 10.1016/j.neurol.2009.06.008. Epub 2009 Sep 9.
Although cognitive disorders are well-known in multiple sclerosis (MS), even in earlier stages of the disease, their management may be overlooked. Our objective was to elaborate and evaluate the efficiency of a remedial program (PROCOG-SEP) designed for MS patients. The evidence-based program proposes exercises to both stimulate preserved functions and develop new abilities compensating for cognitive disabilities.
DESIGN/METHODS: Twenty-four patients with MS participated in 10/2-hour PROCOG-SEP sessions over a 6-month period. A neuropsychologist recorded BCcog-SEP performances before and after the PROCOG-SEP program. In addition, the same neuropsychologist conducted psychoclinical interviews to complete the before and after cognitive evaluations. The statistical analysis used the t-test performed with Excel.
Compared with the initial levels, subtests of BCcog-SEP showing improvement after PROCOG-SEP were: verbal memory (SRT), visuospatial memory (10/36), verbal fluency (animal categories) and response to conflicting orders. Also, individual psychological interviews tended to be in favor of a general improvement in quality of life (more social interactions for instance).
CONCLUSIONS/RELEVANCE: To our knowledge, the management program we have elaborated is the first designed to improve cognitive deficits in MS. These encouraging results suggest possibilities for improving cognition and thus quality-of-life in MS patients.
尽管认知障碍在多发性硬化症(MS)中广为人知,甚至在疾病的早期阶段也是如此,但它们的管理可能会被忽视。我们的目标是精心设计并评估一项针对MS患者的补救计划(PROCOG-SEP)的效果。该循证计划提出了一些练习,既能刺激保留的功能,又能培养新的能力以弥补认知缺陷。
设计/方法:24名MS患者在6个月的时间里参加了10次每次2小时的PROCOG-SEP课程。一名神经心理学家记录了PROCOG-SEP计划前后的BCcog-SEP表现。此外,同一名神经心理学家进行了心理临床访谈,以完成认知评估的前后对比。统计分析使用Excel进行t检验。
与初始水平相比,PROCOG-SEP后BCcog-SEP中显示出改善的子测试包括:言语记忆(SRT)、视觉空间记忆(10/36)、言语流畅性(动物类别)以及对冲突指令的反应。此外,个人心理访谈倾向于支持生活质量的总体改善(例如更多的社交互动)。
结论/意义:据我们所知,我们精心设计的管理计划是首个旨在改善MS认知缺陷的计划。这些令人鼓舞的结果表明了改善MS患者认知从而提高生活质量的可能性。