Multiple Sclerosis Centre Sicilia Region, First Neurology Clinic, University Hospital, and Department of Neurology, University of Catania, Catania, Italy.
Qual Life Res. 2012 Sep;21(7):1111-21. doi: 10.1007/s11136-011-0021-6. Epub 2011 Sep 28.
To report longitudinal changes in and explore the influence of cognition on social functioning in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS).
Italian patients (18-50 years) with RRMS and Expanded Disability Status Scale (EDSS) score ≤4.0 were assigned to interferon β-1a, 44 or 22 μg subcutaneously three times weekly, and underwent annual assessments for social functioning (Environmental Status Scale [ESS]) over 3 years.
Baseline total ESS score did not differ between patients with and without cognitive impairment (P = 0.505). Total ESS score remained low (<2.0) and stable over 3 years in the whole study population, but worsened slightly when assessed by assigned treatment or treatment and baseline cognitive status (both P = 0.004), driven mostly by changes in the 'transportation' and 'financial/economic status' subscales. The strongest independent predictor of worsening ESS score was baseline EDSS score. Test-retest analyses confirmed that total ESS score and most subscales changed little over 3 years.
ESS scores remained low and changed minimally over 3 years, reflecting the mild physical disability and good cognitive performance in this patient population. Determining the influence of cognitive function and treatment on longitudinal changes in social functioning requires further studies.
报告缓解复发型多发性硬化症（RRMS）轻度残疾患者认知功能的纵向变化，并探讨其对社会功能的影响。
将意大利 RRMS 患者（18-50 岁），扩展残疾状态量表（EDSS）评分≤4.0 分，随机分配至皮下注射干扰素β-1a，44μg 或 22μg，每周三次，随访 3 年，每年评估一次社会功能（环境状态量表[ESS]）。
认知障碍患者与无认知障碍患者的基线 ESS 总分无差异（P = 0.505）。在整个研究人群中，ESS 总分在 3 年内保持较低（<2.0）且稳定，但根据分配的治疗或治疗和基线认知状态评估时略有恶化（均 P = 0.004），主要由“交通”和“财务/经济状况”子量表的变化驱动。ESS 评分恶化的最强独立预测因子是基线 EDSS 评分。测试重测分析证实，ESS 总分和大多数子量表在 3 年内变化不大。
ESS 评分在 3 年内保持较低且变化较小，反映了该患者人群的轻度身体残疾和良好的认知表现。确定认知功能和治疗对社会功能纵向变化的影响需要进一步的研究。
