Cabeça Hideraldo Luis Souza, Rocha Luciano Chaves, Sabbá Amanda Ferreira, Tomás Alessandra Mendonça, Bento-Torres Natali Valim Oliver, Anthony Daniel Clive, Diniz Cristovam Wanderley Picanço
Departamento de Neurologia, Hospital Ophir Loyola, Belém, PA, Brazil.
Laboratório de Investigações em Neurodegeneração e Infecção, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brazil.
BMC Neurol. 2018 Sep 10;18(1):140. doi: 10.1186/s12883-018-1141-1.
It is essential to investigate cognitive deficits in multiple sclerosis (MS) to develop evidence-based cognitive rehabilitation strategies. Here we refined cognitive decline assessment using the automated tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) and hierarchical cluster analysis.
We searched for groups of distinct cognitive profiles in 35 relapsing-remitting MS outpatients and 32 healthy controls. All individuals participated in an automated assessment (CANTAB) and in a pencil and paper general neuropsychological evaluation.
Hierarchical cluster analysis of the CANTAB results revealed two distinct groups of patients based mainly on the Simple Reaction Time (RTI) and on the Mean Latency of Rapid Visual Processing (RVP). The general neuropsychological assessment did not show any statistically significant differences between the cluster groups. Compared to the healthy control group, all MS outpatients had lower scores for RTI, RVP, paired associate learning, and delayed matching to sample. We also analyzed the associations between CANTAB results and age, education, sex, pharmacological treatment, physical activity, employment status, and the Expanded Disability Status Scale (EDSS). Although limited by the small number of observations, our findings suggest a weak correlation between performance on the CANTAB and age, education, and EDSS scores.
We suggest that the use of selected large-scale automated visuospatial tests from the CANTAB in combination with multivariate statistical analyses may reveal subtle and earlier changes in information processing speed and cognition. This may expand our ability to define the limits between normal and impaired cognition in patients with Multiple Sclerosis.
研究多发性硬化症（MS）中的认知缺陷对于制定循证认知康复策略至关重要。在此，我们使用剑桥神经心理测试自动成套系统（CANTAB）的自动化测试和层次聚类分析对认知衰退评估进行了优化。
我们在35名复发缓解型MS门诊患者和32名健康对照中寻找不同认知特征组。所有个体均参与了自动化评估（CANTAB）以及纸笔形式的一般神经心理学评估。
对CANTAB结果进行的层次聚类分析显示，主要基于简单反应时（RTI）和快速视觉处理平均潜伏期（RVP）可将患者分为两个不同组。一般神经心理学评估未显示聚类组之间存在任何统计学上的显著差异。与健康对照组相比，所有MS门诊患者在RTI、RVP、配对联想学习和延迟样本匹配方面得分较低。我们还分析了CANTAB结果与年龄、教育程度、性别、药物治疗、身体活动、就业状况以及扩展残疾状态量表（EDSS）之间的关联。尽管受观察数量较少的限制，但我们的研究结果表明CANTAB表现与年龄、教育程度和EDSS评分之间存在弱相关性。
我们建议，将CANTAB中选定的大规模自动化视觉空间测试与多变量统计分析相结合，可能会揭示信息处理速度和认知方面的细微及早期变化。这可能会扩展我们界定多发性硬化症患者正常认知与受损认知界限的能力。
