Papathanasiou Athanasios, Messinis Lambros, Georgiou Vasileios L, Papathanasopoulos Panagiotis
Neuropsychology Section, Department of Neurology, University of Patras Medical School, 265 04 Patras, Greece ; Department of Neurology, Essex Centre for Neurological Sciences, Queen's Hospital, Romford, RM70AG, UK.
Neuropsychology Section, Department of Neurology, University of Patras Medical School, 265 04 Patras, Greece.
ISRN Neurol. 2014 Mar 13;2014:151379. doi: 10.1155/2014/151379. eCollection 2014.
Objective. To investigate the pattern of cognitive impairment in relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS) patients using a computerized battery. Methods. RRMS patients (N = 50), SPMS patients (N = 30), and controls (N = 31) were assessed by Central Nervous System Vital Signs (CNS VS) computerized battery, Trail Making Tests (TMT) A and B, and semantic and phonological verbal fluency tasks. Results. The overall prevalence of cognitive dysfunction was 53.75% (RRMS 38%, SPMS 80%). RRMS patients differed from controls with large effect size on reaction time, medium effect size on TMT A and small on TMT B, phonological verbal fluency, composite memory, psychomotor speed, and cognitive flexibility. SPMS patients differed from controls in all neuropsychological measures (except complex attention) with large effect sizes on TMT A and B, phonological verbal fluency, composite memory, psychomotor speed, reaction time, and cognitive flexibility. Between patient groups, medium effect sizes were present on TMT B and psychomotor speed, while small effect sizes were present on composite memory and processing speed. Conclusion. CNS VS is sensitive in detecting cognitive impairment in RRMS and SPMS patients. Significant impairment in episodic memory, executive function, and processing speed were identified, with gradual increment of the frequency as disease progresses.
目的。使用计算机化测试组来研究复发缓解型多发性硬化症（RRMS）和继发进展型多发性硬化症（SPMS）患者的认知障碍模式。方法。通过中枢神经系统生命体征（CNS VS）计算机化测试组、连线测验（TMT）A和B以及语义和语音语言流畅性任务对RRMS患者（N = 50）、SPMS患者（N = 30）和对照组（N = 31）进行评估。结果。认知功能障碍的总体患病率为53.75%（RRMS为38%，SPMS为80%）。RRMS患者与对照组在反应时间上有较大效应量差异，在TMT A上有中等效应量差异，在TMT B、语音语言流畅性、综合记忆、心理运动速度和认知灵活性上有较小效应量差异。SPMS患者与对照组在所有神经心理学测量指标（复杂注意力除外）上均有差异，在TMT A和B、语音语言流畅性、综合记忆、心理运动速度、反应时间和认知灵活性上有较大效应量差异。在患者组之间，TMT B和心理运动速度上有中等效应量差异，而综合记忆和处理速度上有较小效应量差异。结论。CNS VS对检测RRMS和SPMS患者的认知障碍很敏感。发现情景记忆、执行功能和处理速度有显著损害，且随着疾病进展频率逐渐增加。
