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多发性硬化症患者的认知障碍

Cognitive Disorders in Patients with Multiple Sclerosis.

作者信息

Sehanovic Aida, Smajlovic Dzevdet, Tupkovic Emir, Ibrahimagic Omer C, Kunic Suljo, Dostovic Zikrija, Zoletic Emina, Pasic Zejneba

机构信息

Clinic of Neurology, University Medical Center Tuzla, Tuzla, Bosnia and Herzegovina.

Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.

出版信息

Mater Sociomed. 2020 Sep;32(3):191-195. doi: 10.5455/msm.2020.32.191-195.

Abstract

INTRODUCTION

Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). Cognitive disorders are found in over 50% of patients.

AIM

The aim of the study was to determine the distribution of cognitive disorders in people with MS.

METHODS

The prospective study included 135 respondents with MS and 50 healthy respondents. The respondents were divided into three groups: the first group consisted of 85 respondents where the disease lasted longer than one year, the second group consisted of 50 respondents with newly diagnosed MS, the third group consisted of 50 healthy respondents. Clinical assessment instruments were: Extended Disability Score in Multiple Sclerosis Patients, Mini Mental Status, Battery of Tests to Assess Cognitive Functions: Wechsler Intelligence Scale, Revised Beta Test, Raven Colored Progressive Matrices, Wechsler Memory Scale, Rey Audio Verbal Learning Test -Osterriecht's complex character test, verbal fluency test.

RESULTS

Cognitive disorders were present in 40-60% of respondents with MS. Visuospatial, visuoconstructive and visuoperceptive functions are worse in the first group. Mnestic functions (learning process, short-term and long-term memory, recollection, verbal-logical memory) were most affected in both groups of respondents, ranging from 30-60%. Poorer cognitive domains are in the first groups of respondents. Immediate working process memory (current learning), memory, attention, short-term and logical memory is worse in the examinees of the first group. At the beginning of the disease, 16% had verbal fluency difficulties, and as the disease progresses, the difficulties become more pronounced.

CONCLUSION

Cognitive disorders are heterogeneous, they can be noticed in the early stages of the disease. They refer to impairments of working memory, executive functions and attention, while global intellectual efficiency is later reduced.

摘要

引言

多发性硬化症(MS)是一种中枢神经系统(CNS)的慢性、炎症性(自身)免疫疾病。超过50%的患者存在认知障碍。

目的

本研究的目的是确定MS患者认知障碍的分布情况。

方法

前瞻性研究纳入了135名MS患者和50名健康受试者。受试者被分为三组:第一组由85名病程超过一年的受试者组成,第二组由50名新诊断的MS患者组成,第三组由50名健康受试者组成。临床评估工具包括:多发性硬化症患者扩展残疾评分、简易精神状态检查表、认知功能评估测试组合:韦氏智力量表、修订版贝塔测试、瑞文彩色渐进矩阵、韦氏记忆量表、雷伊听觉词语学习测试 - 奥斯特里希特复杂特征测试、语言流畅性测试。

结果

40 - 60%的MS患者存在认知障碍。第一组的视觉空间、视觉构建和视觉感知功能较差。两组受试者的记忆功能(学习过程、短期和长期记忆、回忆、言语逻辑记忆)受影响最大,范围在30 - 60%。第一组受试者的认知领域较差。第一组受试者的即时工作过程记忆(当前学习)、记忆、注意力、短期和逻辑记忆较差。在疾病初期,16%的患者存在语言流畅性困难,随着疾病进展,困难变得更加明显。

结论

认知障碍具有异质性,在疾病早期即可发现。它们涉及工作记忆、执行功能和注意力的损害,而整体智力效率随后会降低。

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