Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile.
Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile.
Mult Scler Relat Disord. 2018 Feb;20:122-128. doi: 10.1016/j.msard.2018.01.013. Epub 2018 Jan 31.
Cognitive impairment is a relevant contributor of the medical and social burden in Progressive MS. Social Cognition, the neurocognitive processes underlying social interaction, has been explored mainly in European and North American cohorts, influencing social aspects of quality of life (QOL) of early MS patients and families. Few studies have studied Social Cognition in Progressive MS and the literature on its neuroanatomical bases or brain atrophy measurements is still scarce.
To explore the relationship between Social Cognition performance and its correlations with traditional cognitive domains, brain atrophy and QOL in primary and secondary Progressive MS patients.
Cross-sectional analysis including: mini-Social-Cognition-and-Emotional-Assessment (mini-SEA), neuropsychological battery, disability, depression, fatigue, QOL, and brain volume.
Forty-three MS patients, 23 primary and 20 secondary Progressive, 65% women, mean age and disease duration of 57.2 and 15.7 years, respectively, with high levels of disability (median EDSS 6.0) and a widespread impairment in traditional domains (mostly episodic verbal/visual and working memories) were assessed. The Mini-SEA score was correlated with executive functions (cognitive shifts Rho:0.55; p = 0.001) analyzing the whole group, and with visual episodic memory (Rho:0.58, p = 0.009) in the primary Progressive MS group. Mini-SEA score was also correlated with total normalized grey matter volume (Rho:0.48; p = 0.004). Particularly, atrophy within bilateral cortical regions of orbitofrontal, insula and cerebellum, and right regions of fusiform gyrus and precuneus were significantly associated with higher Social Cognition impairment. In this cohort, QOL was not correlated with Social Cognition, but with EDSS, fatigue and depression.
In Progressive MS, Social Cognition is directly correlated with traditional cognitive domains such as executive function and episodic memory. It is also associated with global grey matter atrophy and regional atrophy within associative visual and executive cortical areas, but no correlations with QOL were found in this cohort. These findings may contribute to the understanding of the pathological bases behind Social Cognition in Progressive MS.
认知障碍是进展型多发性硬化（Progressive MS）患者医疗和社会负担的重要因素。社会认知是社交互动的神经认知过程，主要在欧洲和北美队列中进行了研究，影响了早期多发性硬化症患者及其家庭的生活质量（QOL）的社交方面。很少有研究探讨进展型多发性硬化症中的社会认知，关于其神经解剖基础或脑萎缩测量的文献仍然很少。
探讨原发性和继发性进展型多发性硬化症患者社会认知表现与其与传统认知领域、脑萎缩和 QOL 的相关性。
包括横断面分析：迷你社会认知与情绪评估（mini-SEA）、神经心理学测试、残疾、抑郁、疲劳、QOL 和脑容量。
共纳入 43 名多发性硬化症患者，其中 23 名原发性进展型和 20 名继发性进展型，65%为女性，平均年龄和疾病病程分别为 57.2 岁和 15.7 年，残疾程度较高（中位 EDSS 为 6.0），传统认知领域广泛受损（主要为情节性言语/视觉和工作记忆）。在整个组中，Mini-SEA 评分与执行功能（认知转换相关系数：0.55；p = 0.001）相关，在原发性进展型多发性硬化症组中与视觉情节记忆相关（相关系数：0.58，p = 0.009）。Mini-SEA 评分还与总正常化灰质体积相关（相关系数：0.48；p = 0.004）。特别是，双侧眶额皮质、岛叶和小脑、右侧梭状回和楔前叶皮质区域的萎缩与较高的社会认知障碍显著相关。在该队列中，生活质量（QOL）与社会认知无关，但与 EDSS、疲劳和抑郁有关。
在进展型多发性硬化症中，社会认知与执行功能和情节记忆等传统认知领域直接相关。它还与整体灰质萎缩以及与视觉和执行皮质区域相关的区域性萎缩有关，但在该队列中未发现与 QOL 的相关性。这些发现可能有助于理解进展型多发性硬化症中社会认知的病理基础。
