Matias-Guiu Jordi A, Cortés-Martínez Ana, Curiel Rosie E, Delgado-Álvarez Alfonso, Fernández-Oliveira Aníbal, Pytel Vanesa, Montero Paloma, Moreno-Ramos Teresa, Loewenstein David A, Matías-Guiu Jorge
Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain.
Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, United States.
Front Neurol. 2020 Apr 21;11:309. doi: 10.3389/fneur.2020.00309. eCollection 2020.
Episodic memory is frequently impaired in Multiple Sclerosis (MS), but the cognitive characteristics and neuropsychological processes involved remain controversial. Our aim was to study episodic memory dysfunction in MS, using the LASSI-L, a novel memory-based cognitive stress test that uses a new paradigm that capitalizes on semantic interference. Cross-sectional study in which 93 patients with MS (relapsing-remitting) and 124 healthy controls were included. The LASSI-L test was administered to all participants, as well as a comprehensive neuropsychological battery including a selective reminding test. MS patients were divided into two groups, with cognitive impairment (CI-MS) and cognitively preserved (CP-MS). Reliability of the LASSI-L test was high (Cronbach's alpha 0.892) and there were less ceiling effects. MS patients scored lower than controls on all LASSI-L subtests, except for maximum storage of the initial target items (CRA2). Effect sizes were moderate-large. A delay in learning, difficulties in retroactive semantic interference, failure to recover from proactive semantic interference, and delayed recall were the most frequent findings in MS patients. Scores associated with maximum storage capacity, and retroactive semantic interference were the most strongly associated with cognitive impairment and employment status. We found that deficits in maximum learning, difficulties in recovery from the effects of proactive semantic interference and retroactive semantic interference are three important breakdowns in episodic memory deficits among patients with MS. The LASSI-L showed good psychometric and diagnostic properties. Overall, our study supports the utility of the LASSI-L, as a new cognitive test, useful for neuropsychological assessment in MS in clinical and research settings.
发作性记忆在多发性硬化症（MS）中经常受损，但所涉及的认知特征和神经心理过程仍存在争议。我们的目的是使用LASSI-L研究MS中的发作性记忆功能障碍，LASSI-L是一种基于记忆的新型认知应激测试，采用了利用语义干扰的新范式。纳入93例复发缓解型MS患者和124名健康对照者的横断面研究。对所有参与者进行了LASSI-L测试，以及包括选择性提醒测试在内的综合神经心理测验。MS患者分为两组，即认知受损组（CI-MS）和认知未受损组（CP-MS）。LASSI-L测试的信度很高（克朗巴赫α系数为0.892），天花板效应较小。除了初始目标项目的最大存储量（CRA2）外，MS患者在所有LASSI-L子测试中的得分均低于对照组。效应大小为中等至大。学习延迟、追溯性语义干扰困难、无法从前瞻性语义干扰中恢复以及回忆延迟是MS患者最常见的发现。与最大存储容量和追溯性语义干扰相关的分数与认知障碍和就业状况的相关性最强。我们发现，最大学习能力缺陷、从前瞻性语义干扰和追溯性语义干扰的影响中恢复困难是MS患者发作性记忆缺陷的三个重要故障点。LASSI-L显示出良好的心理测量和诊断特性。总体而言，我们的研究支持LASSI-L作为一种新的认知测试在临床和研究环境中对MS进行神经心理评估的实用性。
