Department of Neurology, Louisiana State University Health Sciences Center-New Orleans, 1542 Tulane Ave, Rm 718A, New Orleans, LA 70112, USA.
Curr Neurol Neurosci Rep. 2012 Oct;12(5):618-27. doi: 10.1007/s11910-012-0294-3.
Cognitive impairment (CI) is a serious complication of multiple sclerosis (MS), and the domains affected are well established, but new affected domains such as theory of mind are still being identified. The evidence that disease-modifying therapies (DMTs) improve and prevent the development of CI in MS is not solid. Recent studies on the prevalence of CI in MS among people treated with DMT, although not as solid as studies completed prior to DMT introduction, suggest that CI remains a problem even among people on DMTs and that CI occurs frequently even at the very earliest stages of MS. Functional MRI studies and studies using diffusion tractography show that the impact of lesions on cognition depends on the particular cortical networks affected and their plasticity. Cognitive rehabilitation and L-amphetamine appear promising symptomatic treatments for CI in MS, while, cholinesterase inhibitors and memantine have failed, and data on Ginkgo and exercise are limited. We need more work to understand better CI in MS and develop treatments for this serious complication of MS.
认知障碍（CI）是多发性硬化症（MS）的严重并发症，受影响的领域已得到充分证实，但新的受影响领域，如心理理论，仍在被发现。关于疾病修正疗法（DMT）改善和预防 MS 患者 CI 发展的证据并不确凿。最近关于 DMT 治疗的 MS 患者 CI 患病率的研究，尽管不如 DMT 引入前完成的研究那样确凿，但表明 CI 即使在接受 DMT 的人群中仍然是一个问题，并且 CI 甚至在 MS 的最早阶段也经常发生。功能磁共振成像研究和使用弥散张量成像的研究表明，病变对认知的影响取决于受影响的特定皮质网络及其可塑性。认知康复和 L-苯丙胺似乎是 MS 患者 CI 的有前途的对症治疗方法，而胆碱酯酶抑制剂和美金刚的治疗失败，银杏和运动的数据有限。我们需要更多的工作来更好地了解 MS 中的 CI 并为这一严重的 MS 并发症开发治疗方法。
