DEPARTMENT OF NEUROLOGY, PSYCHIATRY AND PHYSICAL REHABILITATION, KYIV MEDICAL UNIVERSITY, KYIV, UKRAINE.
DEPARTMENT OF NEUROREHABILITATION, UZHHOROD NATIONAL UNIVERSITY, UZHHOROD, UKRAINE.
Wiad Lek. 2021;74(10 pt 1):2444-2451.
The aim: To clarify the influence of different risk factors on cognitive impairment (CI) in general and in separate domains and their association with MRI findings in patients with relapsing-remitting (RRMS) and progressive forms of multiple sclerosis (SPMS and PPMS).
Materials and methods: One hundred and thirty-seven participants with MS (102 females and 35 males) aged from 22 to 69 years were enrolled into this study. All patients completed the Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A) and undergone MRI.
Results: According to MS phenotypes all participants were divided into two groups: patients with RRMS (n= 106) and with progressive phenotypes (n= 31). A significant positive correlation was present between MoCA and BDI scores in all participants (p= 0,0015). Presence of anxiety did not demonstrate any valid influence on cognitive performance, although severe anxiety was significantly more often found in subjects with progressive phenotypes in presence of brain atrophy (p= 0,0028). Patients with higher education had no CI more frequently compare to those without it (p= 0,0019), whereas, participants smoking cigarettes had higher prevalence of severe CI than non-smokers (p= 0,0061).
Conclusions: Among cognitive domains memory, visual-spatial and executive functions, abstract thinking were impaired the most in MS patients, though abstract thinking was more often affected in progressive forms. The results demonstrated that physical disability, depression and smoking negatively impacted cognitive performance, meanwhile presence of higher education demonstrated a favorable influence on cognition in MS patients.
明确不同危险因素对复发缓解型(RRMS)和进展型多发性硬化症(SPMS 和 PPMS)患者认知障碍(CI)及各认知域的影响及其与 MRI 结果的关系。
本研究纳入了 137 名 MS 患者(102 名女性,35 名男性),年龄 22-69 岁。所有患者均完成蒙特利尔认知评估(MoCA)、贝克抑郁量表(BDI)、汉密尔顿焦虑量表(HAM-A)和 MRI 检查。
根据 MS 表型,所有参与者分为两组:RRMS 组(n=106)和进展型组(n=31)。所有参与者的 MoCA 评分与 BDI 评分呈显著正相关(p=0.0015)。尽管在存在脑萎缩的情况下,进展型表型的患者中更常出现严重焦虑,但焦虑的存在对认知表现并无明显影响(p=0.0028)。与未接受过高等教育的患者相比,接受过高等教育的患者发生 CI 的几率更低(p=0.0019),而与不吸烟者相比,吸烟者发生严重 CI 的几率更高(p=0.0061)。
在认知域中,记忆、视觉空间和执行功能、抽象思维在 MS 患者中受损最严重,尽管抽象思维在进展型中更常受到影响。结果表明,躯体残疾、抑郁和吸烟会对认知表现产生负面影响,而接受过高等教育则对 MS 患者的认知表现产生积极影响。