Guenter Wojciech, Bieliński Maciej, Bonek Robert, Borkowska Alina
Department of Clinical Neuropsychology, Nicolaus Copernicus University, 87-100 Toruń, Poland, and Collegium Medicum, 85-094 Bydgoszcz, Poland.
Regional Specialized Hospital in Grudziądz, Division of Neurology and Clinical Neuroimmunology, 86-300 Grudziądz, Poland.
J Clin Med. 2020 Dec 2;9(12):3909. doi: 10.3390/jcm9123909.
To assess cognitive impairment and affective symptoms and their association with damage to normal-appearing white matter (NAWM) in patients with clinically isolated syndrome (CIS), we compared neuropsychological test scores between patients with CIS and healthy controls and examined correlations between these and proton magnetic resonance spectroscopy (H-MRS) outcomes in patients with CIS. Forty patients with CIS and 40 healthy participants were tested with a set of neuropsychological tests, which included the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS). Single-voxel H-MRS was performed on frontal and parietal NAWM of patients with CIS to assess ratios of -acetyl-aspartate (NAA) to creatine (Cr), -inositol (mI), and choline (Cho), as well as mI/Cr and Cho/Cr ratios. Patients with CIS had lower cognitive performance and higher scores for the BDI and anxiety subscale of HADS than healthy controls. There were significant correlations between the following neuropsychological tests and metabolic ratios in the frontal NAWM: Stroop Color-Word Test and Cho/Cr, Symbol Digit Modalities Test and mI/Cr, as well as NAA/mI, Go/no-go reaction time, and NAA/Cho, as well as NAA/mI, Californian Verbal Learning Test, and NAA/Cr. BDI scores were related to frontal NAA/mI and parietal NAA/Cr and Cho/Cr ratios, whereas HADS-depression scores were associated with frontal NAA/Cr and NAA/mI and parietal NAA/Cr and Cho/Cr ratios. HADS-anxiety correlated with parietal NAA/Cr ratio. This study suggests that neurochemical changes in the NAWM assessed with single-voxel H-MRS are associated with cognitive performance and affective symptoms in patients with CIS.
为评估临床孤立综合征（CIS）患者的认知障碍和情感症状及其与正常外观白质（NAWM）损伤的关联，我们比较了CIS患者与健康对照者的神经心理学测试分数，并研究了这些分数与CIS患者质子磁共振波谱（H-MRS）结果之间的相关性。对40例CIS患者和40名健康参与者进行了一系列神经心理学测试，包括贝克抑郁量表（BDI）和医院焦虑抑郁量表（HADS）。对CIS患者的额叶和顶叶NAWM进行单体素H-MRS，以评估N-乙酰天门冬氨酸（NAA）与肌酸（Cr）、肌醇（mI）和胆碱（Cho）的比率，以及mI/Cr和Cho/Cr比率。CIS患者的认知表现低于健康对照者，BDI和HADS焦虑子量表得分高于健康对照者。以下神经心理学测试与额叶NAWM中的代谢比率之间存在显著相关性：Stroop色词测试与Cho/Cr、符号数字模态测试与mI/Cr，以及NAA/mI、停止信号反应时间与NAA/Cho，以及NAA/mI、加利福尼亚言语学习测试与NAA/Cr。BDI得分与额叶NAA/mI以及顶叶NAA/Cr和Cho/Cr比率相关，而HADS抑郁得分与额叶NAA/Cr和NAA/mI以及顶叶NAA/Cr和Cho/Cr比率相关。HADS焦虑与顶叶NAA/Cr比率相关。这项研究表明，用单体素H-MRS评估的NAWM中的神经化学变化与CIS患者的认知表现和情感症状相关。
