Department of Neurology.
Buffalo Neuroimaging Analysis Center.
Cogn Behav Neurol. 2020 Dec;33(4):294-300. doi: 10.1097/WNN.0000000000000252.
Due to increasingly improved disability outcomes, and the resultant significantly improved life span, of the multiple sclerosis (MS) population, questions regarding cognitive aging and the prevalence of comorbid Alzheimer disease (AD) have emerged. We describe neuropsychological and MRI-based changes that occurred in an 84-year-old MS patient with comorbid amnestic mild cognitive impairment (a precursor to AD) and cerebrovascular pathology. The neuropsychological examination demonstrated impairment in cognitive processing speed as well as in verbal and visual memory-domains that are potentially affected by any, or all, of the three co-existing diseases. Amyloid-based PET imaging showed increased focal uptake within the gray matter of the occipital lobe. We highlight how these clinical and radiologic observations can inform future research that could elucidate interactions between MS, a probable AD diagnosis, and cerebrovascular pathology in elderly individuals with MS. A comprehensive neuropsychological examination of multiple cognitive domains of individuals with MS may aid in the differential diagnosis of late-in-life cognitive decline.
由于多发性硬化症（MS）患者的残疾预后和预期寿命显著提高，人们对认知老化和共病阿尔茨海默病（AD）的患病率产生了疑问。我们描述了一位 84 岁多发性硬化症患者的神经心理学和 MRI 变化，该患者患有共病遗忘型轻度认知障碍（AD 的前兆）和脑血管病。神经心理学检查显示认知处理速度以及言语和视觉记忆领域受损，这些可能受到三种共存疾病中的任何一种或全部的影响。基于淀粉样蛋白的 PET 成像显示在枕叶灰质内的局部摄取增加。我们强调了这些临床和影像学观察结果如何为未来的研究提供信息，这些研究可能阐明多发性硬化症、可能的 AD 诊断以及老年多发性硬化症患者的脑血管病之间的相互作用。对多发性硬化症患者的多个认知领域进行全面的神经心理学检查可能有助于对晚年认知能力下降进行鉴别诊断。
