中国视神经脊髓炎患者的认知障碍

Cognitive impairment in Chinese neuromyelitis optica.

作者信息

Zhang N, Li Y J, Fu Y, Shao J H, Luo L L, Yang L, Shi F D, Liu Y

机构信息

Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China/Department of Neurology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, USA.

出版信息

Mult Scler. 2015 Dec;21(14):1839-46. doi: 10.1177/1352458515576982. Epub 2015 Mar 31.

DOI:10.1177/1352458515576982

PMID:25828756

Abstract

BACKGROUND

Cognitive dysfunction is frequently seen in neuromyelitis optica (NMO). However, the features and influencing factors of cognitive impairment of Chinese NMO patients are unclear.

OBJECTIVE

To investigate the patterns of cognitive impairment in Chinese NMO patients, and correlate the neuropsychiatric scores with clinical and MRI parameters.

METHODS

Thirty-six Chinese NMO patients, and 30 sex and age-matched healthy controls were recruited with extensive neuropsychological assessments, using the modified Minimal Assessment of Cognitive Function in MS (MACFIMS). The demographic and clinical characteristics as well as MRI parameters were compared between cognitively impaired (CI) and cognitively preserved (CP) patients.

RESULTS

NMO patients were significantly impaired in the Paced Auditory Serial Addition Task (P<0.05), the Symbol Digit Modalities Test (P<0.001), the California Verbal Learning Test-Second Edition (P<0.05), the Brief Visuospatial Memory Test-Revised (P<0.05) and semantic fluency (P<0.001). Only lower education level was associated with cognitive dysfunction in NMO (odds ratio: 0.57, P<0.05). There were no significant differences of MRI parameters regarding white matter (WM) lesions, grey matter and WM brain volume between CI and CP patients.

CONCLUSIONS

Chinese NMO patients particularly demonstrated cognitive impairment in information processing speed, executive function and memory. Lower education level was the main factor contributing to cognitive impairment in NMO.

摘要

背景

认知功能障碍在视神经脊髓炎（NMO）中较为常见。然而，中国NMO患者认知障碍的特征及影响因素尚不清楚。

目的

探讨中国NMO患者认知障碍的模式，并将神经精神评分与临床及MRI参数相关联。

方法

招募36例中国NMO患者及30例年龄和性别匹配的健康对照者，采用改良的多发性硬化症认知功能简易评估量表（MACFIMS）进行全面的神经心理学评估。比较认知受损（CI）和认知未受损（CP）患者的人口统计学和临床特征以及MRI参数。

结果

NMO患者在听觉连续加法任务（P<0.05）、符号数字模式测验（P<0.001）、加利福尼亚言语学习测验第二版（P<0.05）、简明视觉空间记忆测验修订版（P<0.05）和语义流畅性（P<0.001）方面存在显著受损。在NMO中，仅较低的教育水平与认知功能障碍相关（优势比：0.57，P<0.05）。CI和CP患者在白质（WM）病变、灰质和WM脑容量的MRI参数方面无显著差异。