Department of Human Neurosciences, Sapienza University, Rome, Italy,
Multiple Sclerosis Center, Sapienza University, Rome, Italy,
Dement Geriatr Cogn Disord. 2020;49(6):539-543. doi: 10.1159/000514674. Epub 2021 Mar 18.
Since cognitive impairment (CI) occurs on average in 45% of multiple sclerosis (MS) patients, the early detection of patients "at risk" of CI is important in order to promptly apply preventive strategies. The aim of the present study was to investigate the prevalence and risk factors for CI in MS patients using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) as a screening test.
During the 1-year period, CI was evaluated in 82 consecutives mild relapsing-remitting MS (EDSS ≤ 3.5) patients. Patients with 1 altered BICAMS test were defined "at risk." Both "at risk" and CI patients underwent an extensive neuropsychological battery.
We found that: (i) 23% had CI, (ii), 25% were "at risk" of CI, and (iii) 76% of the "at risk" patients were already impaired at the NP assessment. In particular, the Symbol Digit Modalities Test was the most compromised (70% of "at risk" and 79% of CI patients). Patients with CI had more frequently an EDSS ≥ 2.5 (p = 0.05), lower education (p = 0.05), and relapses in the last 12 months (p = 0.03).
CI is a significant issue in MS and integration of a screening test, such as the SDMT, into routine clinical practice could be of worth to identify "at risk" patients and to promote an early therapeutic intervention.
由于认知障碍（CI）平均出现在 45%的多发性硬化症（MS）患者中，因此早期发现有 CI 风险的患者对于及时应用预防策略非常重要。本研究旨在使用多发性硬化症简短认知评估（BICAMS）作为筛查测试，调查 MS 患者 CI 的患病率和危险因素。
在 1 年期间，对 82 例连续轻度复发缓解型 MS（EDSS≤3.5）患者进行了 CI 评估。将 1 项 BICAMS 测试异常的患者定义为“有风险”。对“有风险”和 CI 患者均进行了广泛的神经心理学测试。
我们发现：（i）23%的患者有 CI；（ii）25%的患者有 CI 风险；（iii）76%的“有风险”患者在 NP 评估中已经受损。特别是，符号数字模态测试受到的影响最大（70%的“有风险”患者和 79%的 CI 患者）。CI 患者的 EDSS≥2.5 的更频繁（p=0.05）、受教育程度较低（p=0.05），且在过去 12 个月中发生了更多的复发（p=0.03）。
CI 是 MS 的一个重要问题，将筛查测试（如 SDMT）纳入常规临床实践可能有助于识别“有风险”患者，并促进早期治疗干预。
