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多发性硬化不同临床病程中的认知障碍

Cognitive impairment among different clinical courses of multiple sclerosis.

作者信息

Brissart Helene, Morele Elodie, Baumann Cedric, Perf Matthieu Le, Leininger Matthieu, Taillemite Laetitia, Dillier Céline, Pittion Sophie, Spitz Elisabeth, Debouverie Marc

机构信息

Central Hospital, CHU de Nancy, Nancy, France.

出版信息

Neurol Res. 2013 Oct;35(8):867-72. doi: 10.1179/1743132813Y.0000000232. Epub 2013 Jun 19.

Abstract

BACKGROUND

As of yet, no consensus has been reached regarding cognitive impairment profiles in multiple sclerosis (MS) patients based on the MS type and disease duration. The main objective of this study was to describe cognitive impairment at the early stages of MS. The secondary objective was to compare cognitive performances in patients with relapsing remitting multiple sclerosis (RRMS), secondary progressive (SP) MS and primary progressive (PP) MS.

METHODS

The study included 128 MS patients and 63 healthy controls (HC). The study constituted five groups: early RR (ERR) (<3 years); late RR (LRR) (>10 years), SP, PP, and healthy Controls (HC). A neuropsychological assessment was performed including information processing speed (IPS), working memory, verbal episodic memory and executive functions.

RESULTS

Compared to HC, only impairment in phonemic fluency was observed in ERR. Slowing IPS, impairment in working memory and phonemic fluency were shown in LRR. In progressive forms, deficits were observed in verbal episodic memory, in working memory, in flexibility, in semantic and phonemic fluencies, with a slowing IPS.

CONCLUSION

Verbal fluency is impaired at early stage of RRMS, in this form of MS, impairment increased with MS duration, and distinct cognitive profiles were observed between chronic and progressive forms.

摘要

背景

截至目前,关于基于多发性硬化症(MS)类型和病程的MS患者认知障碍特征尚未达成共识。本研究的主要目的是描述MS早期的认知障碍。次要目的是比较复发缓解型多发性硬化症(RRMS)、继发进展型(SP)MS和原发进展型(PP)MS患者的认知表现。

方法

该研究纳入了128例MS患者和63名健康对照(HC)。研究分为五组:早期RR(ERR)(<3年);晚期RR(LRR)(>10年)、SP、PP和健康对照(HC)。进行了神经心理学评估,包括信息处理速度(IPS)、工作记忆、言语情景记忆和执行功能。

结果

与HC相比,ERR组仅观察到音素流畅性受损。LRR组出现IPS减慢、工作记忆和音素流畅性受损。在进展型中,言语情景记忆、工作记忆、灵活性、语义和音素流畅性均出现缺陷,IPS减慢。

结论

RRMS早期言语流畅性受损,在这种MS形式中,损伤随MS病程增加,并且在慢性和进展型之间观察到不同的认知特征。

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