Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Arch Clin Neuropsychol. 2013 Mar;28(2):144-55. doi: 10.1093/arclin/acs113. Epub 2013 Jan 4.
It is unclear how cognitive impairment in multiple sclerosis (MS) is influenced by physical disability, fatigue, and depression. Our aim was to identify the strongest clinical predictors for cognitive impairment in relapsing-remitting MS (RRMS) patients. The clinical risk factors included in the analysis were physical disability (EDSS), fatigue (FSS), the somatic and nonsomatic components of depression (BDI), disease progression rate [Multiple Sclerosis Severity Score (MSSS)], and psychotropic medication. Cognitive impairment had a prevalence of 30.5% in patients affecting preferentially attention, executive functions, processing speed and visual perception/organization. MSSS was not associated with cognitive impairment, depression, or fatigue. In regression models, cognitive performance was best predicted by the nonsomatic symptoms of depression alone or in combination with physical disability. Exclusion of patients with any psychotropic medication did not influence the results. Our results underscore the importance of evaluating depressive symptoms when suspecting cognitive impairment in patients with RRMS.
多发性硬化症（MS）患者的认知障碍受身体残疾、疲劳和抑郁的影响程度尚不清楚。我们的目的是确定影响复发缓解型多发性硬化症（RRMS）患者认知障碍的最强临床预测因素。分析中纳入的临床危险因素包括身体残疾（EDSS）、疲劳（FSS）、抑郁的躯体和非躯体成分（BDI）、疾病进展率[多发性硬化严重程度评分（MSSS）]和精神药物。认知障碍在患者中的患病率为 30.5%，主要影响注意力、执行功能、处理速度和视觉感知/组织。MSSS 与认知障碍、抑郁或疲劳无关。在回归模型中，认知表现最好由抑郁的非躯体症状单独或与身体残疾联合预测。排除任何精神药物治疗的患者不会影响结果。我们的研究结果强调了在怀疑 RRMS 患者存在认知障碍时评估抑郁症状的重要性。
