Sadigh-Eteghad Saeed, Abbasi Garravnd Negin, Feizollahi Mahsa, Talebi Mahnaz
Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Persian Medicine, Faculty of Persian Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Clin Neurol. 2021 Jan;17(1):113-120. doi: 10.3988/jcn.2021.17.1.113.
Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS). Although demographic and clinical factors contribute to MS-dependent CI, previous findings have been inconsistent. This study aimed to identify the cognitive domains that are impaired in MS patients, and to determine the impacts of the Expanded Disability Status Scale (EDSS) score and other clinical and demographic factors on them domains.
This study enrolled 115 MS patients. Cognitive performance was assessed using the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery. CI severity was assessed based on the number of impaired tasks in the MACFIMS battery, with impairment in two or more tasks defined as CI cases. Correlation analysis was used to determine whether factors including current age, age at disease onset, EDSS score, disease duration, relapse rate, and education level affect the severity of CI.
The scores on the Paced Auditory Serial Addition Test and Delis-Kaplan Executive Function System were the most and least affected, respectively. EDSS score (=0.438, <0.001), current age (=0.393, <0.001), and disease duration (=0.486, <0.001) were positively correlated with CI severity, whereas education level (=-0.527, <0.001) had a negative correlation with CI severity, and age at disease onset and relapse rate were not correlated with CI severity (=0.150 and =0.107, and =0.052 and =0.530, respectively). However, all variables (except EDSS score) significantly predicted CI severity in a multiple regression model (<0.001, =0.668).
Information processing speed and working memory were the most commonly affected cognitive domains in the present MS patients. CI severity had strong positive correlations with current age, EDSS score, and disease duration, and a negative correlation with education level. The relapse rate and age at disease onset were not correlated with CI severity.
认知障碍（CI）是多发性硬化症（MS）的常见症状。尽管人口统计学和临床因素会导致与MS相关的CI，但先前的研究结果并不一致。本研究旨在确定MS患者受损的认知领域，并确定扩展残疾状态量表（EDSS）评分以及其他临床和人口统计学因素对这些领域的影响。
本研究纳入了115例MS患者。使用多发性硬化症认知功能最小评估量表（MACFIMS）对认知表现进行评估。根据MACFIMS量表中受损任务的数量评估CI严重程度，两项或更多任务受损定义为CI病例。采用相关分析确定当前年龄、发病年龄、EDSS评分、病程、复发率和教育水平等因素是否影响CI严重程度。
听觉系列加法测验（Paced Auditory Serial Addition Test）和德利斯科-卡普兰执行功能系统（Delis-Kaplan Executive Function System）的得分分别受影响最大和最小。EDSS评分（=0.438，<0.001）、当前年龄（=0.393，<0.001）和病程（=0.486，<0.001）与CI严重程度呈正相关，而教育水平（=-0.527，<0.001）与CI严重程度呈负相关，发病年龄和复发率与CI严重程度无相关性（分别为=0.150和=0.107，以及=0.052和=0.530）。然而，在多元回归模型中，所有变量（EDSS评分除外）均显著预测了CI严重程度（<0.001，=0.668）。
信息处理速度和工作记忆是当前MS患者中最常受影响的认知领域。CI严重程度与当前年龄、EDSS评分和病程呈强正相关，与教育水平呈负相关。复发率和发病年龄与CI严重程度无相关性。
