Vollmer Timothy, Huynh Lynn, Kelley Caroline, Galebach Philip, Signorovitch James, DiBernardo Allitia, Sasane Rahul
Department of Neurology, University of Colorado Denver, 12631 East 17th Avenue, Aurora, CO, 80045, USA.
Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA.
Neurol Sci. 2016 Feb;37(2):165-79. doi: 10.1007/s10072-015-2400-1. Epub 2015 Nov 4.
Patients with multiple sclerosis (MS) experience varying rates of brain volume (BV) loss ranging from 0.5 to 1.5 % per year. In addition, 66 % of patients with MS experience cognitive impairment, resulting in impact on daily activities. A systematic literature review (2003-2013) was conducted to identify all studies reporting a relationship between whole BV measures and selected patient outcomes measuring cognition, including the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT) and MS Functional Composite (MSFC) scores. We identified 18 studies reporting associations between whole BV and cognitive outcomes. Six studies (33 %) examined the association between BV and SDMT; all six studies reported that BV loss (BVL) was significantly associated with a decline in SDMT scores (all p < 0.05). Among 14 studies (78 %) that examined the association between BV and PASAT scores, 12 (86 %) found a significant relationship between BVL and lower PASAT scores (all p < 0.05). Of the seven studies (39 %) that looked at BV and MSFC, six studies (86 %) found BVL significantly associated with lower MSFC scores (all p < 0.05). Our study demonstrated that BVL is associated with declines in cognition in MS patients across several cognition measures. The results of this study suggest that BV is a critical component of disease activity and progression in MS and has implications for treatment decisions to minimize BVL and preserve cognitive functioning.
多发性硬化症（MS）患者的脑容量（BV）损失率各不相同，每年在0.5%至1.5%之间。此外，66%的MS患者存在认知障碍，对日常活动产生影响。我们进行了一项系统的文献综述（2003年至2013年），以确定所有报告全脑容量测量与选定的认知患者结局之间关系的研究，这些结局测量包括符号数字模态测试（SDMT）、听觉序列加法测试（PASAT）和MS功能综合评分（MSFC）。我们确定了18项报告全脑容量与认知结局之间关联的研究。六项研究（33%）考察了脑容量与SDMT之间的关联；所有六项研究均报告脑容量损失（BVL）与SDMT评分下降显著相关（所有p<0.05）。在14项考察脑容量与PASAT评分之间关联的研究（78%）中，12项（86%）发现BVL与较低的PASAT评分之间存在显著关系（所有p<0.05）。在七项考察脑容量与MSFC的研究（39%）中，六项研究（86%）发现BVL与较低的MSFC评分显著相关（所有p<0.05）。我们的研究表明，BVL与MS患者在多种认知测量中的认知下降有关。这项研究的结果表明，脑容量是MS疾病活动和进展的关键组成部分，对旨在最小化BVL和保留认知功能的治疗决策具有启示意义。
