Moore Perry, Methley Abigail, Pollard Catherine, Mutch Kerry, Hamid Shahd, Elsone Liene, Jacob Anu
The Walton Centre NHS Foundation Trust, Liverpool, UK.
University of Manchester, UK.
J Neurol Sci. 2016 Jan 15;360:4-9. doi: 10.1016/j.jns.2015.11.031. Epub 2015 Nov 18.
Our primary objective was to examine the neuropsychological and psychopathological profile of patients with neuromyelitis optica (NMO) and compare these to multiple sclerosis (MS) and healthy control (HC) groups. We also examined for relationships between cognitive and psychiatric variables and clinical factors including accumulated neurological disability and disease duration.
A neuropsychological test battery was administered along with a structured psychiatric interview and quantitative measures of mood symptoms.
42 NMO, 42 MS and 42 HC participants were assessed. Cognitive impairments were observed in 67% of NMO patients. The prevalence and profile of cognitive impairments and lifetime prevalence of depression was similar between NMO and MS groups. However, significantly higher rates of recurrent depression and suicidality were observed in NMO patients. Correlational analyses revealed higher levels of anxiety symptoms were associated with shorter disease duration in NMO, while higher depression symptom levels were associated with higher neurological disability and poorer cognition.
Our results demonstrate substantial cognitive and psychiatric comorbidities in NMO patients. Similar rates of lifetime and current depression between NMO and MS appear to mask greater underlying psychiatric burden in NMO and further understandings of the course of neurobehavioural comorbidities is required to better comprehend the additional morbidity in NMO. Our data support a role for cognitive and psychiatric assessments in the comprehensive care of NMO patients.
我们的主要目的是研究视神经脊髓炎（NMO）患者的神经心理学和精神病理学特征，并将这些特征与多发性硬化症（MS）患者及健康对照组（HC）进行比较。我们还研究了认知和精神变量与包括累积神经功能残疾和病程在内的临床因素之间的关系。
实施一套神经心理学测试，同时进行结构化精神科访谈和情绪症状的定量测量。
对42名NMO患者、42名MS患者和42名HC参与者进行了评估。67%的NMO患者存在认知障碍。NMO组和MS组的认知障碍患病率及特征以及抑郁症的终生患病率相似。然而，NMO患者中复发性抑郁症和自杀倾向的发生率显著更高。相关性分析显示，NMO患者中焦虑症状水平较高与病程较短相关，而抑郁症状水平较高与神经功能残疾程度较高及认知较差相关。
我们的结果表明NMO患者存在大量认知和精神共病。NMO和MS之间相似的终生及当前抑郁症发生率似乎掩盖了NMO中更大的潜在精神负担，需要进一步了解神经行为共病的病程，以更好地理解NMO中的额外发病率。我们的数据支持在NMO患者的综合护理中进行认知和精神评估。
