一大群早期多发性硬化症患者的治疗选择和神经心理学症状
Treatment choices and neuropsychological symptoms of a large cohort of early MS.
作者信息
von Bismarck Olga, Dankowski Theresa, Ambrosius Björn, Hessler Nicole, Antony Gisela, Ziegler Andreas, Hoshi Muna-Miriam, Aly Lilian, Luessi Felix, Groppa Sergiu, Klotz Luisa, Meuth Sven G, Tackenberg Björn, Stoppe Muriel, Then Bergh Florian, Tumani Hayrettin, Kümpfel Tania, Stangel Martin, Heesen Christoph, Wildemann Brigitte, Paul Friedemann, Bayas Antonios, Warnke Clemens, Weber Frank, Linker Ralf A, Ziemann Ulf, Zettl Uwe K, Zipp Frauke, Wiendl Heinz, Hemmer Bernhard, Gold Ralf, Salmen Anke
机构信息
Department of Neurology (O.v.B., B.A., R.G., A.S.), St. Josef-Hospital, Ruhr-University Bochum; Institute of Medical Biometry and Statistics (T.D., N.H., A.Z.), University of Lübeck, University Hospital Schleswig-Holstein, Campus Lübeck; Central Information Office (CIO) (G.A.), Philipps-University Marburg, Germany; School of Mathematics (A.Z.), Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa; Department of Neurology (M.-M.H., L.A., B.H.), Klinikum rechts der Isar, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (L.A., B.H.); Department of Neurology (F.L., S.G., F.Z.), University Medicine Mainz, Johannes Gutenberg University Mainz; Department of Neurology (L.K., S.G.M., H.W.), University Hospital Münster; Department of Neurology (B.T.), Philipps-University Marburg; Department of Neurology (M.Stoppe, F.T.B.), University of Leipzig; Department of Neurology (H.T.), University of Ulm; Clinic of Neurology Dietenbronn (H.T.), Schwendi; Institute of Clinical Neuroimmunology (T.K.), Ludwig Maximilian University of Munich; Department of Neurology (M.Stangel), Hannover Medical School; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf; Department of Neurology (B.W.), University of Heidelberg; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (F.P.), Charité-University Medicine Berlin and Max Delbrueck Center for Molecular Medicine; Department of Neurology (A.B.), Klinikum Augsburg; Department of Neurology (C.W.), Heinrich-Heine-University, Düsseldorf; Department of Neurology (C.W.), University Hospital Köln; Neurology (F.W.), Max-Planck-Institute of Psychiatry, Munich; Neurological Clinic (F.W.), MATERNUS Kliniken AG, Bad Oeynhausen; Department of Neurology (R.A.L.), University Hospital Erlangen; Department of Neurology & Stroke (U.Z.), Hertie Institute for Clinical Brain Research, Eberhard-Karls-University Tübingen; Department of Neurology (U.K.Z.), University of Rostock, Germany; and Department of Neurology (A.S.), Inselspital Bern, University Hospital and University of Bern, Switzerland.
出版信息
Neurol Neuroimmunol Neuroinflamm. 2018 Mar 1;5(3):e446. doi: 10.1212/NXI.0000000000000446. eCollection 2018 May.
OBJECTIVE
To assess clinical characteristics, distribution of disease-modifying treatments (DMTs), and neuropsychological symptoms in a large cohort of patients with early-stage MS.
METHODS
The German National MS Cohort is a multicenter prospective longitudinal cohort study that has recruited DMT-naive patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS) since 2010. We evaluated their baseline characteristics and the prevalence of neuropsychological symptoms.
RESULTS
Of 1,124 patients, with a 2.2:1 female-to-male ratio and median age at onset of 31.71 years (interquartile range [IQR]: 26.06-40.33), 44.6% and 55.3% had CIS and RRMS, respectively. The median Expanded Disability Status Scale (EDSS) score at baseline was 1.5 (IQR: 1.0-2.0). A proportion of 67.8% of patients started DMT after a median time of 167.0 days (IQR 90.0-377.5) since the first manifestation. A total of 64.7% and 70.4% of the 762 patients receiving early DMT were classified as CIS and RRMS, respectively. Fatigue, depressive symptoms, and cognitive dysfunction were detected in 36.5%, 33.5%, and 14.7% of patients, respectively.
CONCLUSION
Baseline characteristics of this large cohort of patients with early, untreated MS corroborated with other cohorts. Most patients received early DMT within the first year after disease onset, irrespective of a CIS or RRMS diagnosis. Despite the low EDSS score, neuropsychological symptoms affected a relevant proportion of patients.
目的
评估一大群早期多发性硬化症（MS）患者的临床特征、疾病修正治疗（DMT）的分布情况以及神经心理症状。
方法
德国国家MS队列研究是一项多中心前瞻性纵向队列研究，自2010年起招募未接受过DMT治疗的临床孤立综合征（CIS）和复发缓解型MS（RRMS）患者。我们评估了他们的基线特征和神经心理症状的患病率。
结果
在1124例患者中，女性与男性比例为2.2:1，发病年龄中位数为31.71岁（四分位间距[IQR]：26.06 - 40.33），分别有44.6%和55.3%的患者患有CIS和RRMS。基线时扩展残疾状态量表（EDSS）评分中位数为1.5（IQR：1.0 - 2.0）。自首次出现症状起，67.8%的患者在中位数时间167.0天（IQR 90.0 - 377.5）后开始接受DMT治疗。在762例接受早期DMT治疗的患者中，分别有64.7%和70.4%被归类为CIS和RRMS。分别有36.5%、33.5%和14.7%的患者检测出疲劳、抑郁症状和认知功能障碍。
结论
这一大群早期未治疗的MS患者的基线特征与其他队列研究结果相符。大多数患者在疾病发作后的第一年内接受了早期DMT治疗，无论诊断为CIS还是RRMS。尽管EDSS评分较低，但神经心理症状影响了相当一部分患者。
Zotero 插件