Department of Clinical Research, Hokkaido Medical Center, Yamanote 5jo 7chome, Nishi-ku, Sapporo 063-0005, Japan.
BMC Neurol. 2014 Jan 6;14:3. doi: 10.1186/1471-2377-14-3.
Cognitive impairment could affect quality of life for patients with multiple sclerosis (MS), and cognitive function may be correlated with several factors such as depression and fatigue. This study aimed to evaluate cognitive function in Japanese patients with MS and the association between cognitive function and apathy, fatigue, and depression.
The Brief Repeatable Battery of Neuropsychological tests (BRB-N) was performed in 184 Japanese patients with MS and 163 healthy controls matched for age, gender, and education. The Apathy Scale (AS), Fatigue Questionnaire (FQ), and Beck Depression Inventory Second Edition (BDI-II) were used to evaluate apathy, fatigue, and depression, respectively. Student's t-test was used to compare MS patients and healthy controls. Correlations between two factors were assessed using the Pearson correlation test, and multiple regression analysis was used to evaluate how much each factor affected the BRB-N score.
In all BRB-N tests, patients with MS scored significantly lower than controls, and the effect size of symbol digit modalities test was the highest among the 9 tests of the BRB-N. Patients with MS had higher AS (p < 0.001), FQ (p < 0.0001), and BDI-II (p < 0.0001) scores than controls. In patients with MS, scores on most of the BRB-N tests correlated with scores on the AS and BDI-II; however, there was little correlation between scores on the BRB-N tests and those on the FQ.
Cognitive function was impaired, particularly information-processing speed, and decreased cognitive function was correlated with apathy and depression in Japanese patients with MS. Despite the association between cognitive variables and depression/apathy, cognitive function was impaired beyond the effect of depression and apathy. However, subjective fatigue is not related with cognitive impairment. Taken together, this suggests that different therapeutic approaches are needed to improve subjective fatigue and cognition, and thereby quality of life, in patients with MS.
认知障碍可能会影响多发性硬化症（MS）患者的生活质量，认知功能可能与抑郁和疲劳等多种因素相关。本研究旨在评估日本 MS 患者的认知功能，以及认知功能与淡漠、疲劳和抑郁之间的关系。
对 184 例日本 MS 患者和 163 例年龄、性别和教育程度相匹配的健康对照者进行简短重复神经心理测试（BRB-N）。采用淡漠量表（AS）、疲劳问卷（FQ）和贝克抑郁量表第二版（BDI-II）分别评估淡漠、疲劳和抑郁。采用学生 t 检验比较 MS 患者和健康对照组。采用 Pearson 相关检验评估两因素之间的相关性，采用多元回归分析评估各因素对 BRB-N 评分的影响程度。
BRB-N 所有测试中，MS 患者的评分均显著低于对照组，且符号数字模态测试的效应量在 BRB-N 的 9 项测试中最高。MS 患者的 AS（p<0.001）、FQ（p<0.0001）和 BDI-II（p<0.0001）评分均高于对照组。MS 患者中，BRB-N 测试的大部分评分与 AS 和 BDI-II 评分相关，但 BRB-N 测试的评分与 FQ 评分相关性较小。
日本 MS 患者的认知功能受损，尤其是信息处理速度，且认知功能下降与淡漠和抑郁相关。尽管认知变量与抑郁/淡漠相关，但认知功能受损程度超出了抑郁和淡漠的影响。然而，主观疲劳与认知障碍无关。综上所述，这表明需要采取不同的治疗方法来改善 MS 患者的主观疲劳和认知，从而提高其生活质量。
