Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Neurol Sci. 2010 Mar 15;290(1-2):75-9. doi: 10.1016/j.jns.2009.11.004. Epub 2009 Nov 26.
Cognitive deficits are common in patients with multiple sclerosis (MS) and may be observed early in the course of the disease. Current knowledge about the association between cognitive impairment and health-related quality of life (HQOL) in patients with early MS is limited. We used a well-established battery of cognitive tests and standardized HQOL measures to examine the associations between overall and domain-specific cognitive performance and quality of life in patients with early MS. Ninety-two patients with CIS or MS diagnosed in the previous three years participating in the CLIMB Natural History Study underwent a neurologic examination, neuropsychological evaluation and quality of life assessment. Associations between cognitive scores and HQOL measures were examined. There were no differences between cognitively impaired versus unimpaired subjects on any of the HQOL measures. After controlling for depression, scores on tests of information processing speed were significantly associated with several measures of HQOL including physical well-being, fatigue, and social support. In all cases, correlations between HQOL and cognitive measures were mild. These findings were observed in patients with limited cognitive impairment and minimal physical disability. Our results suggest that cognitive remediation programs aimed at improving cognitive skills may also improve quality of life for patients with early MS.
认知缺陷在多发性硬化症 (MS) 患者中很常见，并且可能在疾病早期就观察到。目前，关于早期 MS 患者认知障碍与健康相关生活质量 (HQOL) 之间的关联的知识有限。我们使用了经过验证的认知测试和标准化的 HQOL 措施，以研究早期 MS 患者整体和特定领域认知表现与生活质量之间的关系。92 名 CIS 或过去三年内诊断出的 MS 患者参加了 CLIMB 自然史研究，他们接受了神经系统检查、神经心理学评估和生活质量评估。检查了认知评分与 HQOL 测量之间的关联。在任何 HQOL 测量中，认知受损与未受损的受试者之间没有差异。在控制了抑郁后，信息处理速度测试的分数与 HQOL 的几个测量指标显著相关，包括身体状况、疲劳和社会支持。在所有情况下，HQOL 和认知测量之间的相关性都很弱。这些发现见于认知损害有限和身体残疾最小的患者中。我们的研究结果表明，旨在改善认知技能的认知矫正计划也可能改善早期 MS 患者的生活质量。
