Donaldson Emily, Patel Viral P, Shammi Prathiba, Feinstein Anthony
Department of Psychiatry.
Neuropsychology Consultation Service, Sunnybrook Health Sciences Centre, Toronto, Canada.
Cogn Behav Neurol. 2019 Mar;32(1):39-45. doi: 10.1097/WNN.0000000000000188.
Cognitive dysfunction affects 40% to 70% of people with multiple sclerosis (MS). Sex may influence a person's cognition. Although a few studies have reported greater cognitive deficits in men than women, it is unclear whether specific cognitive domains are more vulnerable than others to the effects of sex or whether cognition is influenced by neurologic or psychiatric variables.
A chart review was undertaken of 408 people with MS referred to neuropsychological services. Demographic and MS-related variables were extracted from the patients' records. We used the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis for the neuropsychological assessment. Raw test scores were converted to z scores using Canadian regression-based normative means. A general linear model was conducted on the adjusted scores, controlling for age; years of education; disease course; illness duration; and disability, anxiety, and depression scores.
Men were more likely than women to have primary progressive MS (χ=6.415, P=0.011). There were no other sex differences with respect to demographic, neurologic, or psychiatric data. Women performed significantly better than men on the California Verbal Learning Test-Second Edition Total Learning index (F=7.846, P=0.006).
An analysis of a large, consecutive sample of people with MS demonstrated that sex, independent of demographic, neurologic, or psychiatric factors, is an important determinant in cognitive impairment, with men being more impaired than women on tests of verbal learning and memory.
认知功能障碍影响40%至70%的多发性硬化症（MS）患者。性别可能会影响一个人的认知。尽管有一些研究报告称男性的认知缺陷比女性更严重，但尚不清楚特定的认知领域是否比其他领域更容易受到性别的影响，或者认知是否受神经或精神变量的影响。
对408名转诊至神经心理服务部门的MS患者进行了病历回顾。从患者记录中提取人口统计学和与MS相关的变量。我们使用多发性硬化症认知功能最小评估量表进行神经心理评估。使用基于加拿大回归的常模均值将原始测试分数转换为z分数。对调整后的分数进行一般线性模型分析，控制年龄、教育年限、病程、疾病持续时间以及残疾、焦虑和抑郁评分。
男性比女性更易患原发性进行性MS（χ=6.415，P=0.011）。在人口统计学、神经学或精神病学数据方面没有其他性别差异。在加利福尼亚言语学习测试第二版总学习指数上，女性的表现明显优于男性（F=7.846，P=0.006）。
对一大组连续的MS患者样本进行分析表明，性别独立于人口统计学、神经学或精神病学因素，是认知障碍的一个重要决定因素，在言语学习和记忆测试中，男性比女性受损更严重。
