Henry Audrey, Lannoy Séverine, Chaunu Marie-Pierre, Tourbah Ayman, Montreuil Michèle
Cognition, Health and Society Lab, University of Reims Champagne-Ardenne, France.
Psychopathology and Neuropsychology Lab, University of Paris 8, Saint-Denis, France.
J Neuropsychol. 2022 Mar;16(1):97-115. doi: 10.1111/jnp.12248. Epub 2021 May 14.
Multiple sclerosis (MS) is associated with deficits in social cognition, the process underlying social interaction and cognitive function. However, the relationships between executive impairment and social cognition remain unclear in MS. Previous studies exclusively focused on group comparisons between healthy controls and patients with MS, treating the latter as a homogeneous population. The variability of socio- and neurocognitive profiles in this pathology therefore remains underexplored. In the present study, we used a cluster analytic approach to explore the heterogeneity of executive and social cognition skills in MS. A total of 106 patients with MS were compared with 53 healthy matched controls on executive (e.g., working memory) and social cognition (facial emotion recognition and theory of mind) performances. A cluster analysis was then performed, focusing on the MS sample, to explore the presence of differential patterns of interaction between executive and social cognition difficulties and their links to sociodemographic, clinical and cognitive variables. We identified three distinct functional profiles: patients with no executive or social cognition deficits (Cluster 1); patients with difficulties in facial emotion recognition and theory of mind and, to a lesser extent, executive functioning (Cluster 2); and patients with executive functioning difficulties only (Cluster 3). Clinical characteristics (disease duration, disability, fatigue) did not differ between clusters. CONCLUSIONS: These results suggest that there are qualitative differences in the social cognition and executive difficulties that are commonly found among patients with MS. If replicated, the identification of these profiles in clinical practice could allow for more individualized rehabilitation.
多发性硬化症（MS）与社会认知缺陷有关，而社会认知是社会互动和认知功能的基础过程。然而，在MS中，执行功能障碍与社会认知之间的关系仍不明确。以往的研究仅专注于健康对照者与MS患者之间的组间比较，将后者视为一个同质群体。因此，这种病理状态下社会和神经认知特征的变异性仍未得到充分探索。在本研究中，我们采用聚类分析方法来探究MS患者执行功能和社会认知技能的异质性。总共106例MS患者与53名健康匹配对照者在执行功能（如工作记忆）和社会认知（面部情绪识别和心理理论）表现方面进行了比较。然后对MS样本进行聚类分析，以探究执行功能和社会认知困难之间不同的相互作用模式及其与社会人口统计学、临床和认知变量的联系。我们确定了三种不同的功能类型：无执行功能或社会认知缺陷的患者（第1组）；面部情绪识别和心理理论有困难且执行功能有较轻困难的患者（第2组）；仅执行功能有困难的患者（第3组）。各聚类之间的临床特征（病程、残疾、疲劳）没有差异。结论：这些结果表明，MS患者中常见的社会认知和执行功能困难存在质性差异。如果得到重复验证，在临床实践中识别这些类型将有助于实现更个性化的康复治疗。
