Artemiadis Artemios K, Anagnostouli Maria C, Zalonis Ioannis G, Chairopoulos Konstantinos G, Triantafyllou Nikos I
First Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Athens, Greece.
Department of Neurology, Army Share Fund Hospital (NIMTS), Athens, Greece.
J Clin Neurophysiol. 2018 Sep;35(5):399-407. doi: 10.1097/WNP.0000000000000473.
Cognitive impairment in multiple sclerosis has been associated with cognitive event-related potentials and MRI abnormalities. This study aims to explore for the first time the association between P300 and MRI in multiple sclerosis.
Fifty-eight relapsing-remitting patients (41.5 ± 10.5 years old, 41 women, disease duration 139.7 ± 84.9 months) and 51 healthy controls were used. Visual P300 responses and a set of 2- or 3-dimensional MRI indices were obtained. Neuropsychological testing and psychological evaluations were also performed.
Multiple sclerosis patients had significantly lower P300 amplitude and more prolonged P300 latencies and reaction times than healthy controls. In total, 67.2% of patients were identified with abnormal P300 response. These patients had greater disability and physical fatigue and had lower visuospatial memory scores than those with normal P300 response. Abnormally low P300 amplitude was associated with lower peripheral gray matter volume and was correlated only with normalized frontal horn width and normalized brain volume, after adjusting for age and education. The moderating role of brain reserve was also documented.
P300 event-related potential was related to both linear and volumetric MRI markers. Future studies should expand these results in other disease types and longitudinally. Event-related potentials could serve as an ancillary tool for cognitive assessment in multiple sclerosis.
多发性硬化症中的认知障碍与认知事件相关电位及MRI异常有关。本研究旨在首次探索多发性硬化症中P300与MRI之间的关联。
纳入58例复发缓解型患者（年龄41.5±10.5岁，女性41例，病程139.7±84.9个月）和51名健康对照者。获取视觉P300反应及一组二维或三维MRI指标。还进行了神经心理学测试和心理评估。
与健康对照者相比，多发性硬化症患者的P300波幅显著降低，P300潜伏期和反应时间延长。总计67.2%的患者被确定为P300反应异常。这些患者的残疾程度和身体疲劳程度更高，视觉空间记忆得分低于P300反应正常的患者。在调整年龄和教育程度后，异常低的P300波幅与外周灰质体积降低有关，且仅与标准化额角宽度和标准化脑体积相关。还记录了脑储备的调节作用。
P300事件相关电位与线性和体积MRI标记物均有关。未来研究应在其他疾病类型中纵向扩展这些结果。事件相关电位可作为多发性硬化症认知评估的辅助工具。
