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早期使用高剂量β-1a干扰素治疗可逆转多发性硬化症中的认知和皮质可塑性缺陷。

Early treatment with high-dose interferon beta-1a reverses cognitive and cortical plasticity deficits in multiple sclerosis.

作者信息

Mori Francesco, Kusayanagi Hajime, Buttari Fabio, Centini Barbara, Monteleone Fabrizia, Nicoletti Carolina Gabri, Bernardi Giorgio, Di Cantogno Elisabetta Verdun, Marciani Maria Grazia, Centonze Diego

机构信息

UOSD CSM, Clinica Neurologica, Policlinico Tor Vergata, Rome, Italy. francesco@virgillio

出版信息

Funct Neurol. 2012 Jul-Sep;27(3):163-8.

Abstract

Acute inflammation is associated with cognitive deficits and alterations of cortical plasticity in multiple sclerosis (MS). We tested whether early treatment with high-dose interferon (IFN) beta-1a, known to reduce inflammatory activity, improves cortical function and cognitive deficits in MS. Eighty treatment-naïve relapsing-remitting MS (RRMS)patients received IFN beta-1a (44 mcg) subcutaneously three times per week. Cognitive performance and cortical plasticity were measured through the paced auditory serial addition test (PASAT) and intermittent theta burst stimulation (iTBS) before and up to two years af-ter IFN beta-1a initiation. Before treatment, patients with gadolinium-enhancing lesions (Gd+) on MRI performed worse on the PASAT,and showed lower iTBS-induced plasticity, compared with Gd- patients. Six months after treatment initiation both PASAT and iTBS-induced plasticity improved in Gd+ and remained stable in Gd- patients. These results suggest that cognitive and synaptic plasticity deficits may be rescued during high-doseIFN beta-1a treatment in newly-diagnosed RRMS patients with Gd+ lesions.

摘要

急性炎症与多发性硬化症(MS)中的认知缺陷和皮质可塑性改变有关。我们测试了早期使用已知可降低炎症活性的高剂量干扰素(IFN)β-1a进行治疗是否能改善MS患者的皮质功能和认知缺陷。80名未接受过治疗的复发缓解型MS(RRMS)患者每周皮下注射三次IFNβ-1a(44微克)。在开始使用IFNβ-1a之前以及之后长达两年的时间里,通过听觉连续加法试验(PASAT)和间歇性θ波爆发刺激(iTBS)来测量认知表现和皮质可塑性。治疗前,MRI上有钆增强病变(Gd+)的患者在PASAT上表现较差,并且与Gd-患者相比,iTBS诱导的可塑性较低。治疗开始六个月后,Gd+患者的PASAT和iTBS诱导的可塑性均有所改善,而Gd-患者则保持稳定。这些结果表明,在新诊断的有Gd+病变的RRMS患者接受高剂量IFNβ-1a治疗期间,认知和突触可塑性缺陷可能得到挽救。

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