Neurology Service, Hospital de Santo António, Porto, Portugal/Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto - UMIB/ICBAS/UP
Neurology Service, Hospital de Santo António, Porto, Portugal/Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto - UMIB/ICBAS/UP.
Mult Scler. 2015 Sep;21(10):1312-21. doi: 10.1177/1352458515581874. Epub 2015 May 6.
Recent data suggest that cognitive reserve modulates the adverse effects of multiple sclerosis (MS) pathology on cognitive functioning; however, the protective effects of education in MS are still unclear.
To explore education as an indicator of cognitive reserve, while controlling for demographic, clinical and genetic features.
A total of 419 MS patients and 159 healthy comparison (HC) subjects underwent a comprehensive neuropsychological (NP) assessment, and answered the Hospital Anxiety and Depression Scale. Based on the HC data, MS patients' NP scores were adjusted for sex, age and education; and the estimated 5(th) percentile (or 95(th) percentile, when appropriate) was used to identify any deficits. Patients also performed the Mini-Mental State Examination (MMSE); and their human leucocyte antigen HLA-DRB1 and apolipoprotein E (ApoE) genotypes were investigated.
Patients with higher education were less likely (p < 0.05) to have cognitive deficits than those with lower education, even when controlling for other covariates. Other significant predictors of cognitive deficit were: age, Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Scale (MSSS), and a progressive course. No significant association was found with the HLA-DRB1*15:01 or ApoE ε4 alleles.
These results provide support to the use of education as a proxy of cognitive reserve in MS and stress the need to take into account education when approaching cognition in MS.
最近的数据表明，认知储备调节了多发性硬化症（MS）病理对认知功能的不良影响；然而，教育在 MS 中的保护作用仍不清楚。
在控制人口统计学、临床和遗传特征的情况下，探讨教育作为认知储备的指标。
共有 419 名 MS 患者和 159 名健康对照组（HC）受试者接受了全面的神经心理学（NP）评估，并回答了医院焦虑和抑郁量表。基于 HC 数据，调整了 MS 患者的 NP 分数，以性别、年龄和教育程度为变量；并使用估计的第 5 百分位数（或第 95 百分位数，在适当的情况下）来识别任何缺陷。患者还进行了简易精神状态检查（MMSE）；并研究了他们的人类白细胞抗原 HLA-DRB1 和载脂蛋白 E（ApoE）基因型。
与受教育程度较低的患者相比，受教育程度较高的患者更不容易出现认知缺陷（p<0.05），即使在控制了其他协变量的情况下也是如此。认知缺陷的其他显著预测因素包括：年龄、扩展残疾状态量表（EDSS）、多发性硬化症严重程度量表（MSSS）和进展性病程。与 HLA-DRB1*15:01 或 ApoE ε4 等位基因无显著相关性。
这些结果为在 MS 中使用教育作为认知储备的替代指标提供了支持，并强调在研究 MS 中的认知时需要考虑教育因素。
