Gromisch Elizabeth S, Dhari Zaenab
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA.
Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA.
Neuropsychiatr Dis Treat. 2021 Feb 5;17:323-337. doi: 10.2147/NDT.S256689. eCollection 2021.
Multiple sclerosis (MS) is a debilitating disease of the central nervous system that is most commonly seen in early to middle adulthood, although it can be diagnosed during childhood or later in life. While cognitive impairment can become more prevalent and severe as the disease progresses, signs of cognitive involvement can be apparent in the early stages of the disease. In this review, we discuss the prevalence and types of cognitive impairment seen in early MS, including the specific measures used to identify them, as well as the challenges in characterizing their frequency and progression. In addition to examining the progression of early cognitive involvement over time, we explore the clinical factors associated with early cognitive involvement, including demographics, level of physical disability, disease modifying therapy use, vocational status, and psychological and physical symptoms. Given the prevalence and functional impact these impairments can have for persons with MS, considerations for clinicians are provided, such as the role of early cognitive screenings and the importance of comprehensive neuropsychological assessments.
多发性硬化症（MS）是一种中枢神经系统的致残性疾病，最常见于成年早期至中年，不过在儿童期或生命后期也可被诊断出来。虽然随着疾病进展，认知障碍可能会变得更加普遍和严重，但在疾病早期阶段，认知受累的迹象就可能很明显。在本综述中，我们讨论了早期MS中所见认知障碍的患病率和类型，包括用于识别它们的具体措施，以及在描述其频率和进展方面所面临的挑战。除了研究早期认知受累随时间的进展情况外，我们还探讨了与早期认知受累相关的临床因素，包括人口统计学特征、身体残疾程度、疾病修正治疗的使用、职业状况以及心理和身体症状。鉴于这些障碍对MS患者的患病率和功能影响，我们为临床医生提供了一些考虑因素，例如早期认知筛查的作用以及全面神经心理学评估的重要性。
