多发性硬化症患者的血清肿瘤坏死因子-α水平与认知功能量表评分相关。
Serum Tumor Necrosis Factor-Alpha Levels Correlate with Cognitive Function Scales Scores in Multiple Sclerosis Patients.
机构信息
Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
出版信息
Mult Scler Relat Disord. 2021 Jan;47:102621. doi: 10.1016/j.msard.2020.102621. Epub 2020 Nov 8.
BACKGROUND
Cognitive dysfunction is an important feature and source of disability for patients with multiple sclerosis (MS). The correlation of cognitive function scales' scores and serum levels of the proinflammatory cytokine tumor necrosis factor-alpha (TNF-α) in MS is not well established. We aim to investigate the correlation of TNF-α serum levels with cognitive function as measured by multiple cognitive scales in patients with MS.
METHODS
Eligible sequential MS patients attending neurology clinics between October 2018 and June 2019 at King Abdulla University Hospital (KAUH) in Jordan were included. Demographic data were collected from all participants. Motor disability was measured using the Expanded Disability Status Score (EDSS), the Functional System Score (FSS), as well as the Patient Determined Disease Steps (PDDS). The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and the Montreal Cognitive Assessment (MOCA) were used to evaluate the cognitive status. TNF-α serum levels were measured for each patient. Correlations of TNF-α levels with cognitive function scales' scores and motor disability scores were statistically analyzed.
RESULTS
A total of 88 MS patients were included in the study. The mean age (± SD) was 35.78 (± 10.30) years, and 72.7% were females. The majority of patients (82) had relapsing multiple sclerosis (RMS). Serum TNF-α levels were significantly correlated with scores of motor disability scales in the whole patient cohort (EDSS: Pearson correlation coefficient r = 0.230, p=0.031; FSS: r = 0.260, p=0.022; and PDDS: r = 0.261, p=0.014) and in females, but not in males. In the whole cohort, the correlation between TNF-α and EDSS score was also statistically significant (r = 0.216, p=0.047) after adjustment for confounding factors including age, disease duration, and type of MS. Likewise, Serum TNF-α levels were correlated with the scores of cognitive function scales in the whole patient cohort (BICAMS: r = -0.328, p=0.002; and MOCA: r = -0.256, p=0.016). After adjusting for age, gender, education, type of MS, and EDSS score, cognitive performance was still negatively correlated with TNF-α levels (p<0.05).
CONCLUSION
Our findings confirm the presence of a significant correlation between TNF-α levels and different cognitive scales' scores in MS patients.
背景
认知功能障碍是多发性硬化症（MS）患者的重要特征和致残原因。MS 患者的细胞因子肿瘤坏死因子-α（TNF-α）与认知功能量表评分之间的相关性尚不清楚。我们旨在研究 MS 患者的 TNF-α 血清水平与多项认知量表测量的认知功能之间的相关性。
方法
本研究纳入了 2018 年 10 月至 2019 年 6 月在约旦阿卜杜拉国王大学医院（KAUH）神经内科就诊的符合条件的连续 MS 患者。所有参与者均收集了人口统计学数据。使用扩展残疾状况评分（EDSS）、功能系统评分（FSS）和患者确定疾病步骤（PDDS）测量运动残疾。采用简短国际认知评估多发性硬化症（BICAMS）和蒙特利尔认知评估（MOCA）评估认知状况。测量了每位患者的 TNF-α 血清水平。统计分析了 TNF-α 水平与认知功能量表评分和运动残疾评分之间的相关性。
结果
本研究共纳入 88 例 MS 患者。平均年龄（± SD）为 35.78（± 10.30）岁，72.7%为女性。大多数患者（82 例）为复发性多发性硬化症（RMS）。血清 TNF-α 水平与整个患者队列的运动残疾量表评分显著相关（EDSS：Pearson 相关系数 r = 0.230，p = 0.031；FSS：r = 0.260，p = 0.022；PDDS：r = 0.261，p = 0.014），在女性中相关，但在男性中不相关。在整个队列中，在校正包括年龄、疾病持续时间和 MS 类型在内的混杂因素后，TNF-α 与 EDSS 评分之间的相关性也具有统计学意义（r = 0.216，p = 0.047）。同样，血清 TNF-α 水平与整个患者队列的认知功能量表评分相关（BICAMS：r = -0.328，p = 0.002；MOCA：r = -0.256，p = 0.016）。在校正年龄、性别、教育程度、MS 类型和 EDSS 评分后，认知表现仍与 TNF-α 水平呈负相关（p<0.05）。
结论
我们的研究结果证实，MS 患者的 TNF-α 水平与不同认知量表评分之间存在显著相关性。
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