Carotenuto Antonio, Arcara Giorgio, Orefice Giuseppe, Cerillo Ilaria, Giannino Valentina, Rasulo Mario, Iodice Rosa, Bambini Valentina
Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.
San Camillo Hospital IRCCS, Venice, Italy.
Arch Clin Neuropsychol. 2018 Mar 1;33(2):194-205. doi: 10.1093/arclin/acx061.
Cognitive functions have been largely investigated in multiple sclerosis. Less attention has been paid to social communication abilities, despite their presumptive affect on quality of life. We run the first comprehensive assessment of pragmatic skills in multiple sclerosis, evaluating also the relationship between pragmatics and other cognitive domains.
Forty-two multiple sclerosis patients and 42 controls were tested for pragmatic abilities, neuro-cognition, social cognition, depression, and fatigue.
Patients performed poorly in most pragmatic tasks compared to controls. Globally, 55% of patients performed below the 5th percentile in the total pragmatic score. Notably, pragmatic skills did not differ between cognitively impaired and unimpaired patients. However, an association was found between pragmatics and verbal fluency, as measured in the Word List Generation. Finally, we observed an association of pragmatic abilities with social cognition, and a trend with psychosocial functioning.
Overall, the study shows a diffuse pragmatic impairment in multiple sclerosis, not associated with the patient's global neuropsychological profile. By contrast, our findings suggest a close relation between pragmatics and specific cognitive aspects such as executive functions, and between pragmatics and social cognition. This study underlines the need of looking beyond classical cognitive performance, to consider underestimated communicative disturbances of high clinical relevance.
在多发性硬化症中，认知功能已得到大量研究。尽管社交沟通能力可能会对生活质量产生影响，但却较少受到关注。我们首次对多发性硬化症患者的语用技能进行了全面评估，同时也评估了语用学与其他认知领域之间的关系。
对42名多发性硬化症患者和42名对照者进行了语用能力、神经认知、社会认知、抑郁和疲劳方面的测试。
与对照组相比，患者在大多数语用任务中表现较差。总体而言，55%的患者在语用总分上低于第5百分位数。值得注意的是，认知受损和未受损患者的语用技能没有差异。然而，在词汇表生成测试中，语用学与言语流畅性之间存在关联。最后，我们观察到语用能力与社会认知之间存在关联，并且与心理社会功能存在一定趋势。
总体而言，该研究表明多发性硬化症患者存在广泛的语用障碍，且与患者的整体神经心理特征无关。相比之下，我们的研究结果表明语用学与特定认知方面（如执行功能）以及语用学与社会认知之间存在密切关系。这项研究强调了需要超越经典认知表现，考虑具有高度临床相关性但被低估的沟通障碍。
