Portaccio E
Department of NEUROFARBA, University of Florence, Florence, Italy.
Acta Neurol Scand. 2016 Sep;134 Suppl 200:14-8. doi: 10.1111/ane.12652.
Cognitive impairment is common in multiple sclerosis (MS), affecting up to 70% of patients. One of the most important possible confounders to cognitive assessment is the occurrence of depression, a common consequence of MS. Cognition and depression have been linked in recent neuropsychiatric research that proposed a number of neurocognitive models of mood disorders. According to these models, primary failure of key brain regions of emotional processing and regulation or abnormal connectivity between them contributes to the adoption of maladaptive cognitive strategies and the development of mood disorders. In MS, a similar interplay between cognitive function and depression has been reported. In particular, depression seems to alter attentional capacity in terms of deficits in working memory and, more specifically, deficits in the executive control. However, cognitive impairment in MS does exist also in the absence of depression and it is more likely that depression exacerbates existing cognitive difficulties rather than cause them per se. On the other hand, it is possible that a dysexecutive syndrome secondary to MS might in turn precipitate depression.
认知障碍在多发性硬化症（MS）中很常见，影响多达70%的患者。认知评估中最重要的可能混杂因素之一是抑郁症的发生，这是MS的常见后果。在最近的神经精神病学研究中，认知与抑郁症之间存在联系，该研究提出了一些情绪障碍的神经认知模型。根据这些模型，情绪处理和调节的关键脑区的原发性功能衰竭或它们之间的异常连接导致了适应不良认知策略的采用和情绪障碍的发展。在MS中，也有报道称认知功能与抑郁症之间存在类似的相互作用。特别是，抑郁症似乎会在工作记忆缺陷方面改变注意力容量，更具体地说，是执行控制方面的缺陷。然而，MS中的认知障碍在没有抑郁症的情况下也确实存在，而且更有可能的是，抑郁症会加剧现有的认知困难，而不是本身导致这些困难。另一方面，MS继发的执行功能障碍综合征反过来可能会引发抑郁症。
