Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA/Department of Neurology, Harvard Medical School, Boston, MA, USA/Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA/Department of Neurology, Harvard Medical School, Boston, MA, USA.
Mult Scler. 2021 Apr;27(4):593-602. doi: 10.1177/1352458520913439. Epub 2020 Mar 31.
Although cognitive problems have been identified in people with multiple sclerosis (PwMS), few studies have investigated the long-term change in cognitive functioning.
To identify trajectories of change in cognitive functioning for PwMS.
Participants enrolled in the quality-of-life subgroup from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women's Hospital (CLIMB) were eligible for our analysis. In 2006, participants in this group began to complete the Symbol Digit Modalities Test (SDMT) annually. Latent trajectory models were used to identify groups of participants with similar longitudinal change in SDMT scores. Linear and quadratic trajectory models were fit, and the models were compared. Latent trajectory models were also fit adjusting for baseline age and disease duration as well as using normalized SDMT scores. The groups identified across the approaches were compared.
We found that classes with higher-than-average baseline values improved, classes with average baseline values remained relatively constant, and classes with lower baseline values experienced cognitive worsening. Similar results were observed in the alternative latent trajectory models accounting for other variables.
Our models show that subjects with higher SDMT scores at baseline showed improvement, while subjects with lower SDMT scores at baseline showed worsening. Baseline age and disease duration were also associated with SDMT performance.
尽管多发性硬化症（MS）患者存在认知问题，但很少有研究调查认知功能的长期变化。
确定多发性硬化症患者认知功能变化的轨迹。
有资格参加我们分析的是来自布里格姆妇女医院（Brigham and Women's Hospital）全面纵向多发性硬化症研究（Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women's Hospital，CLIMB）质量生活分组的参与者。2006 年，该组的参与者开始每年完成符号数字模态测试（SDMT）。使用潜在轨迹模型来识别 SDMT 评分具有相似纵向变化的参与者群体。拟合线性和二次轨迹模型，并比较模型。还通过调整基线年龄和疾病持续时间以及使用标准化 SDMT 分数来拟合潜在轨迹模型。比较了通过各种方法确定的组。
我们发现基线值较高的类别的认知能力提高了，基线值中等的类别相对保持不变，而基线值较低的类别认知能力恶化了。在考虑其他变量的替代潜在轨迹模型中也观察到了类似的结果。
我们的模型表明，基线 SDMT 得分较高的受试者表现出改善，而基线 SDMT 得分较低的受试者则表现出恶化。基线年龄和疾病持续时间也与 SDMT 表现相关。
