Cinar Bilge Piri, Kösehasanoğulları Görkem, Yigit Pinar, Ozakbas Serkan
Department of Neurology, Samsun Training and Research Hospital, Samsun, Turkey.
Department of Neurology, Usak State Hosapital, Usak, Turkey.
Neurol Sci. 2017 Feb;38(2):337-342. doi: 10.1007/s10072-016-2775-7. Epub 2016 Nov 24.
Multiple sclerosis (MS) can impair cognitive functions even in the early stages. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery is very short and highly sensitive and can be used to evaluate cognitive status in the disease. Several clinical trials have shown beneficial effects of disease-modifying drugs (DMDs) on long-term cognitive measures which may even reduce cognitive deficits in MS patients. Relapsing remitting MS patients using DMDs were enrolled in the study and monitored for 12 months. BICAMS and the Expanded Disability Status Scale were applied to the study group. We evaluated and monitored 161 newly diagnosed cases of definite MS by the end of the trial. 110 patients (68.2%) were female. One hundred and two healthy subjects (female to male ratio 68:34) were enrolled into the study. MS patients were categorized into three DMT groups: IFNB1-a SC, IFNB1-b, and GA. Mean scores of all three cognitive tests (SDMT, BVMT-R, and CVLT-II) were significantly higher in the control group than in the MS patients. The number of cognitively impaired patients decreased from 31.7 to 21.7% on the basis of CVLT (p = 0.024), and 42 (26.1%) to 30 (18.6%) on the basis of BVMT-R at month 12. A significant difference was determined in terms of cognitive status between MS patients using both IFNB and GA and the healthy control group. Ours is the first study to compare IFNB and GA in terms of evaluating cognitive involvement and to use the BICAMS battery in monitoring treatment.
多发性硬化症(MS)即使在早期阶段也会损害认知功能。简短国际多发性硬化症认知评估量表(BICAMS)测试时间很短且灵敏度很高,可用于评估该疾病的认知状态。多项临床试验表明,疾病修正药物(DMDs)对长期认知指标有有益影响,甚至可能减少MS患者的认知缺陷。本研究纳入了使用DMDs的复发缓解型MS患者,并对其进行了12个月的监测。研究组应用了BICAMS和扩展残疾状态量表。在试验结束时,我们评估并监测了161例新确诊的明确MS病例。110例患者(68.2%)为女性。102名健康受试者(女性与男性比例为68:34)被纳入研究。MS患者被分为三个DMT组:IFNB1-a皮下注射组、IFNB1-b组和GA组。对照组所有三项认知测试(符号数字模式测试、雷伊听觉词语学习测验修订版和加利福尼亚语言学习测验第二版)的平均得分均显著高于MS患者。基于加利福尼亚语言学习测验,认知受损患者的数量从31.7%降至21.7%(p = 0.024),基于雷伊听觉词语学习测验修订版,在第12个月时从42例(26.1%)降至30例(18.6%)。使用IFNB和GA的MS患者与健康对照组在认知状态方面存在显著差异。我们的研究是第一项比较IFNB和GA在评估认知受累方面的差异以及使用BICAMS测试来监测治疗效果的研究。