Department of Neurology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy.
Neurol Sci. 2010 Nov;31(Suppl 2):S261-4. doi: 10.1007/s10072-010-0436-9.
Cognitive dysfunctions are frequent in multiple sclerosis and have a negative impact on employment and quality of life. Pathophysiology of impaired mental activities is probably multifactorial including sensory deafferentation, lesion-related disconnection of associative areas (cortico-cortical and cortico-thalamic), involvement of normal appearing white and gray matter, and direct effects of products of inflammation. Available immunomodulatory treatments for multiple sclerosis may have a role in MS-related cognitive dysfunction because they positively impact some of the pathogenetic studies. Pivotal phase III clinical trials have effectively shown some benefit, confirmed by some post marketing studies. However, results of these studies must be interpreted with great caution because many methodological problems may undermine the quality of the studies.
认知功能障碍在多发性硬化症中很常见，对就业和生活质量有负面影响。精神活动受损的病理生理学可能是多因素的，包括感觉去传入、与病变相关的联合区域（皮质-皮质和皮质-丘脑）的连接中断、正常外观的白质和灰质的参与，以及炎症产物的直接影响。多发性硬化症的现有免疫调节治疗可能在多发性硬化症相关认知功能障碍中发挥作用，因为它们对一些发病机制研究有积极影响。关键性 III 期临床试验有效地显示出一些益处，一些上市后研究也得到了证实。然而，必须非常谨慎地解释这些研究的结果，因为许多方法学问题可能会降低研究的质量。
