Yildiz Murat, Tettenborn Barbara, Radue Ernst-Wilhelm, Bendfeldt Kerstin, Borgwardt Stefan
Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Clin Neurol Neurosurg. 2014 Dec;127:54-8. doi: 10.1016/j.clineuro.2014.09.019. Epub 2014 Oct 14.
Cognitive impairment (CI) can be demonstrated in 40-65% of multiple sclerosis (MS) patients, sometimes starting from the early stages of the disease. The objective of this study was a community-based investigation of FLAIR-hyperintense lesion volumes (LV) and their association with CI in patients with relapsing remitting (RR) MS. The neurocognitive assessment was conducted with the brief cognitive screening instrument, MUSIC. Magnetic resonance imaging (MRI) scans were obtained with a 1.5 Tesla Sigma Magnetom MRI scanner. We conducted a stepwise multiple regression analysis to assess the relative contribution of the main clinical, demographic and MRI-variables in predicting cognitive impairment. We recruited 78 patients with RRMS. The mean MUSIC score was 20.6 ± 5.4. Forty five percent of patients (n = 35, mean score 15.1 ± 3.3) had CI and 55% (n = 43, mean score 24.4 ± 2.5) had no sign of CI. In the correlation analysis of the MUSIC subtests only the interference test correlated negatively with the LV (r = -0.23). Multivariate linear regression analysis using MUSIC as the dependent continuous variable revealed LV and disability severity as independent factors associated with MUSIC (p value of the regression model < 0.001; adjusted R-square = 0.11). The results of the present study suggest an association between white matter damage and CI in MS. We could demonstrate an association between attention difficulties and the LV in MS patients.
ClinicalTrials.gov Identifier: NCT01250665 and NCT01250678.
40%-65%的多发性硬化症(MS)患者可出现认知障碍(CI),有时在疾病早期就开始出现。本研究的目的是基于社区调查复发缓解型(RR)MS患者的液体衰减反转恢复序列(FLAIR)高信号病变体积(LV)及其与CI的关联。使用简短认知筛查工具MUSIC进行神经认知评估。使用1.5特斯拉Sigma Magnetom MRI扫描仪进行磁共振成像(MRI)扫描。我们进行了逐步多元回归分析,以评估主要临床、人口统计学和MRI变量在预测认知障碍中的相对贡献。我们招募了78例RRMS患者。MUSIC评分的平均值为20.6±5.4。45%的患者(n = 35,平均评分15.1±3.3)有CI,55%(n = 43,平均评分24.4±2.5)没有CI迹象。在MUSIC子测试的相关性分析中,只有干扰测试与LV呈负相关(r = -0.23)。以MUSIC作为连续因变量的多元线性回归分析显示,LV和残疾严重程度是与MUSIC相关的独立因素(回归模型的p值<0.001;调整后的决定系数R² = 0.11)。本研究结果提示MS中白质损伤与CI之间存在关联。我们能够证明MS患者的注意力困难与LV之间存在关联。
ClinicalTrials.gov标识符:NCT01250665和NCT01250678。