Ludus-Neuropsychology, Helsinki, Finland; Department of Neurology, Hyvinkää hospital, Hyvinkää, Finland.
Acta Neurol Scand. 2014 Mar;129(3):184-91. doi: 10.1111/ane.12161. Epub 2013 Jun 15.
Cognitive impairment occurs in multiple sclerosis already in the early stages of the disease. Less is known about the evolution of cognitive decline, especially in newly diagnosed MS patients. The results of existing studies are contradictory in that both cognitive preservation and progressive deterioration have been reported. The purpose of this study was to examine how cognitive impairment evolves over time in the early stages of MS.
At baseline, the participants were 36 newly diagnosed MS patients and 37 controls. A group of 30 patients were followed longitudinally at a mean test-retest interval of 6.1 years. The test battery covered attention, information processing, memory and learning, verbal and motor functions and reasoning.
There was a significant decline in divided attention (dual task) and information-processing speed (SDMT) at follow-up, but no significant deterioration in overall cognitive performance.
Overall cognitive functioning remained quite stable during the 6-year follow-up, whereas divided attention and processing speed deteriorated. However, deterioration in performance on the SDMT and the dual task does not seem to indicate more extensive cognitive deterioration. Given the impact of cognitive impairment on patients' quality of life, early detection of its occurrence in MS is extremely important.
认知障碍在多发性硬化症的早期阶段就已经出现。关于认知能力下降的演变，特别是在新诊断的 MS 患者中，人们知之甚少。现有研究的结果存在矛盾之处，因为既有报道称认知能力得到了保持，也有报道称认知能力在逐渐恶化。本研究旨在探讨多发性硬化症早期认知障碍随时间的演变情况。
在基线时，参与者包括 36 名新诊断的 MS 患者和 37 名对照者。一组 30 名患者进行了纵向随访，平均测试-重测间隔为 6.1 年。测试电池涵盖注意力、信息处理、记忆和学习、言语和运动功能以及推理。
随访时，注意力分散（双重任务）和信息处理速度（SDMT）显著下降，但整体认知表现无明显恶化。
在 6 年的随访期间，整体认知功能相当稳定，而注意力分散和处理速度下降。然而，SDMT 和双重任务的表现恶化似乎并不表明更广泛的认知恶化。鉴于认知障碍对患者生活质量的影响，早期发现多发性硬化症中认知障碍的发生极其重要。
