Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation.
Faculty of Medicine, Department of Neurology, Gazi University, Ankara, Turkey.
Int J Rehabil Res. 2020 Dec;43(4):316-323. doi: 10.1097/MRR.0000000000000428.
The factors associated with cognitive functions in patients with multiple sclerosis (PwMS) are not yet clear. The aims of this study were (1) to compare clinical features and physical performance in healthy controls, and PwMS with and without cognitive impairment, and (2) to determine the relationship between cognitive domains and demographics characteristics, clinical features and physical performance in PwMS. A total of 112 PwMS and 25 healthy controls participated in this study. Cognitive functions were evaluated by Brief Repeatable Battery of Neuropsychological Tests (BRB-N). Based on cognitive performances by BRB-N, PwMS were divided into two groups as MS patients with impaired (MS-I, n: 57) and with normal (MS-N, n: 55) cognitive functions. For clinical features, fatigue, mood and sleep quality were evaluated by the Fatigue Impact Scale, Beck's Depression Inventory, Pittsburgh Sleep Quality Index, respectively. For physical performances, balance and walking capacity were evaluated by posturography and Six-Minute Walking Test, respectively. The results showed that the education years, postural stability and walking capacity in MS-N and healthy controls were higher than in MS-I (P < 0.05). In addition, visuospatial memory was correlated with both postural stability under all sensory conditions and walking capacity; verbal memory was correlated with education years, postural stability on eyes closed-foam surface and walking capacity; verbal fluency was correlated with only walking capacity; information processing speed was correlated with education years, postural stability under all sensory conditions and walking capacity (P < 0.001). This study suggests that the interventions that aim to improve physical performance might protect and even improve cognitive functions in PwMS.
多发性硬化症(MS)患者认知功能的相关因素尚不清楚。本研究旨在:(1)比较健康对照组和认知障碍组与非认知障碍组 MS 患者的临床特征和身体表现;(2)确定认知领域与人口统计学特征、临床特征和 MS 患者身体表现之间的关系。共纳入 112 名 MS 患者和 25 名健康对照者。采用简短重复神经心理测试(BRB-N)评估认知功能。根据 BRB-N 的认知表现,MS 患者分为认知功能受损(MS-I,n=57)和认知功能正常(MS-N,n=55)两组。采用疲劳影响量表(FIS)、贝克抑郁量表(BDI)和匹兹堡睡眠质量指数(PSQI)分别评估疲劳、情绪和睡眠质量等临床特征。采用姿势描记术和 6 分钟步行试验分别评估平衡和步行能力等身体表现。结果显示,MS-N 组和健康对照组的教育年限、姿势稳定性和步行能力均高于 MS-I 组(P<0.05)。此外,视空间记忆与所有感觉条件下的姿势稳定性和步行能力均相关;言语记忆与教育年限、闭眼-泡沫表面的姿势稳定性和步行能力相关;言语流畅性仅与步行能力相关;信息处理速度与教育年限、所有感觉条件下的姿势稳定性和步行能力相关(P<0.001)。本研究提示,改善身体表现的干预措施可能有助于保护甚至改善 MS 患者的认知功能。