Department Neurology, Hospital Universitario-Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia; School of Medicine, Universidad El Bosque, Carrera 7B Bis No. 132-11, Bogotá, Colombia; School of Medicine, Universidad de Los Andes, Carrera 1 No. 18A-12, Bogotá, Colombia; Multiple Sclerosis and other Neurological Disorders Research Group, Fundacion Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia.
Multiple Sclerosis and other Neurological Disorders Research Group, Fundacion Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia.
Mult Scler Relat Disord. 2018 May;22:148-152. doi: 10.1016/j.msard.2018.04.011. Epub 2018 Apr 18.
Multiple sclerosis (MS) is a demyelinating disease with a lifetime prevalence of 4.41/100000 in Bogota, Colombia. It is known that it can be related with neuropsychiatric disorders, increasing by a factor of three the prevalence of depression in MS patients compared to general population. However, less attention has been given to the association between MS and impulsive behavior.
This cross-sectional study compared the levels of impulsivity controlling for the presence of MS. 60 patients with MS and 60 sex- and age-matched subjects without MS were included. In order to assess depression and impulsivity, participants completed the 13-item short form of the Beck Depression Inventory (BDI-SF), the self-report Barratt Impulsiveness Scale version 11 (BIS-11) and the Immediate and Delayed Memory Tasks (IMT-DMT) as an objective measure of impulsive behavior.
Total scores, motor and cognitive subscales on the BIS-11 were significantly higher in the MS group. However, median BDI-SF score was also higher in MS patients than in subjects without MS (p < 0.001). To rule out depression as a confounding factor, stratification was performed using the BDI-SF score. In the subgroup of individuals with a BDI-SF< 8, the BIS-11 cognitive subscale scores were significantly higher in patients with MS than in subjects without MS (p = 0.041). In the IMT/DMT test, subjects with MS had a fewer number of correct detections than did subjects without MS, after controlling for BDI-SF score (p = 0.0001/p = 0.003). The ratio of commission errors to correct detections in the IMT was significantly higher in the MS group (p = 0.011).
Patients with MS showed higher levels of cognitive impulsivity than subjects without MS. Objective measures for impulsiveness further support this finding. Impulsiveness scales scores might be biased by depression, which should be considered when assessing impulsivity in MS.
多发性硬化症（MS）是一种脱髓鞘疾病，在哥伦比亚波哥大的终生患病率为 4.41/100000。已知它可能与神经精神障碍有关，使 MS 患者的抑郁患病率比普通人群增加三倍。然而，人们对 MS 与冲动行为之间的关联关注较少。
这项横断面研究比较了控制 MS 存在的情况下的冲动控制水平。纳入了 60 名 MS 患者和 60 名性别和年龄匹配的无 MS 患者。为了评估抑郁和冲动，参与者完成了贝克抑郁量表 13 项简短版（BDI-SF）、Barratt 冲动量表 11 版（BIS-11）和即时和延迟记忆任务（IMT-DMT），作为冲动行为的客观测量。
MS 组的 BIS-11 总分、运动和认知子量表得分显著较高。然而，MS 患者的 BDI-SF 中位数得分也高于无 MS 患者（p<0.001）。为了排除抑郁作为混杂因素，使用 BDI-SF 得分进行分层。在 BDI-SF<8 的个体亚组中，MS 患者的 BIS-11 认知子量表得分显著高于无 MS 患者（p=0.041）。在 IMT/DMT 测试中，控制 BDI-SF 评分后，MS 患者的正确检测次数少于无 MS 患者（p=0.0001/p=0.003）。MS 组的 IMT 中错误检测与正确检测的比例明显更高（p=0.011）。
MS 患者的认知冲动性水平高于无 MS 患者。冲动性的客观测量进一步支持了这一发现。冲动性量表评分可能受到抑郁的影响，在评估 MS 中的冲动性时应考虑到这一点。
