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多发性硬化症中的认知和语言缺陷:复发缓解型与继发进展型亚型的比较

Cognitive and Language Deficits in Multiple Sclerosis: Comparison of Relapsing Remitting and Secondary Progressive Subtypes.

作者信息

Ntoskou Katerina, Messinis Lambros, Nasios Grigorios, Martzoukou Maria, Makris Giorgos, Panagiotopoulos Elias, Papathanasopoulos Panagiotis

机构信息

Rehabilitation unit for Patients with Spinal Cord Injury, "Demetrios and Vera Sfikas", Department of Medicine, University of Patras, 26504 Patras, Greece.

Neuropsychology Section, Department of Neurology, University of Patras Medical School, 26504 Patras, Greece.

出版信息

Open Neurol J. 2018 Mar 12;12:19-30. doi: 10.2174/1874205X01812010019. eCollection 2018.

Abstract

OBJECTIVE

The objective of this study was to investigate the pattern and severity of cognitive and language impairment in Greek patients with Relapsing-remitting (RRMS) and Secondary Progressive Multiple Sclerosis (SPMS), relative to control participants.

METHOD

A prospective study was conducted in 27 patients with multiple sclerosis (PwMS), (= 15) with RRMS, (= 12) with SPMS, and (= 12) healthy controls. All participants were assessed with a flexible comprehensive neuropsychological - language battery of tests that have been standardized in Greece and validated in Greek MS patients. They were also assessed on measures of disability (Expanded Disability Status Scale; EDSS), fatigue (Fatigue Severity Scale; FSS) and depression (Beck Depression Inventory - fast screen; BDI-FS).

RESULTS

Our results revealed that groups were well matched on baseline demographic and clinical characteristics. The two clinical groups (RRMS; SPMS) did not differ on overall global cognitive impairment but differed in the initial encoding of verbal material, mental processing speed, response inhibition and set-shifting. RRMS patients differed from controls in the initial encoding of verbal material, learning curve, delayed recall of verbal information, processing speed, and response inhibition. SPMS patients differed in all utilized measures compared to controls. Moreover, we noted increased impairment frequency on individualized measures in the progressive SPMS group.

CONCLUSION

We conclude that MS patients, irrespective of clinical subtype, have cognitive deficits compared to healthy participants, which become increasingly worse when they convert from RRMS to SPMS.On the contrary,the pattern of impairment remains relatively stable.

摘要

目的

本研究的目的是调查复发缓解型(RRMS)和继发进展型多发性硬化症(SPMS)希腊患者相对于对照参与者的认知和语言障碍模式及严重程度。

方法

对27名多发性硬化症患者(PwMS)进行了一项前瞻性研究,其中15名RRMS患者,12名SPMS患者,以及12名健康对照者。所有参与者均接受了一套灵活的综合神经心理学 - 语言测试组合,该组合已在希腊进行了标准化,并在希腊MS患者中得到验证。他们还接受了残疾程度(扩展残疾状态量表;EDSS)、疲劳(疲劳严重程度量表;FSS)和抑郁(贝克抑郁量表 - 快速筛查;BDI-FS)的评估。

结果

我们的结果显示,各研究组在基线人口统计学和临床特征方面匹配良好。两个临床组(RRMS;SPMS)在总体全球认知障碍方面没有差异,但在言语材料的初始编码、心理处理速度、反应抑制和任务转换方面存在差异。RRMS患者在言语材料的初始编码、学习曲线、言语信息的延迟回忆、处理速度和反应抑制方面与对照组不同。与对照组相比,SPMS患者在所有使用的测量指标上均存在差异。此外,我们注意到进展型SPMS组在个体化测量指标上的损伤频率增加。

结论

我们得出结论,与健康参与者相比,MS患者无论临床亚型如何都存在认知缺陷,当他们从RRMS转变为SPMS时,这些缺陷会变得越来越严重。相反,损伤模式保持相对稳定。

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