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使用数字工具评估多发性硬化症的认知功能:观察性研究。

Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study.

机构信息

Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.

Neuroscape, University of California, San Francisco, CA, United States.

出版信息

J Med Internet Res. 2021 Dec 30;23(12):e25748. doi: 10.2196/25748.

Abstract

BACKGROUND

Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive.

OBJECTIVE

To improve access to CI assessment, we evaluated the feasibility and potential assessment sensitivity of a tablet-based cognitive battery in patients with MS.

METHODS

In total, 53 participants with MS (24 [45%] with CI and 29 [55%] without CI) and 24 non-MS participants were assessed with a tablet-based cognitive battery (Adaptive Cognitive Evaluation [ACE]) and standard cognitive measures, including the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). Associations between performance in ACE and the SDMT/PASAT were explored, with group comparisons to evaluate whether ACE modules can capture group-level differences.

RESULTS

Correlations between performance in ACE and the SDMT (R=-0.57, P<.001), as well as PASAT (R=-0.39, P=.01), were observed. Compared to non-MS and non-CI MS groups, the CI MS group showed a slower reaction time (CI MS vs non-MS: P<.001; CI MS vs non-CI MS: P=.004) and a higher attention cost (CI MS vs non-MS: P=.02; CI MS vs non-CI MS: P<.001).

CONCLUSIONS

These results provide preliminary evidence that ACE, a tablet-based cognitive assessment battery, provides modules that could potentially serve as a digital cognitive assessment for people with MS.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03569618; https://clinicaltrials.gov/ct2/show/NCT03569618.

摘要

背景

认知障碍(CI)是多发性硬化症(MS)最常见的症状之一。然而,由于全面的神经心理学检查通常既耗时又广泛,因此很难将认知评估纳入 MS 的标准护理中。

目的

为了改善认知障碍评估的可及性,我们评估了基于平板电脑的认知电池在 MS 患者中的可行性和潜在评估敏感性。

方法

共有 53 名 MS 患者(24 名[45%]有 CI,29 名[55%]无 CI)和 24 名非 MS 参与者接受了基于平板电脑的认知电池(适应性认知评估[ACE])和标准认知测试,包括符号数字模态测试(SDMT)和听觉连续加法测试(PASAT)。探讨了 ACE 与 SDMT/PASAT 之间的相关性,通过组间比较来评估 ACE 模块是否可以捕捉到组间差异。

结果

ACE 与 SDMT(R=-0.57,P<.001)以及 PASAT(R=-0.39,P=.01)之间存在相关性。与非 MS 和非 CI MS 组相比,CI MS 组的反应时间较慢(CI MS 与非 MS:P<.001;CI MS 与非 CI MS:P=.004),注意力成本较高(CI MS 与非 MS:P=.02;CI MS 与非 CI MS:P<.001)。

结论

这些结果初步表明,基于平板电脑的认知评估电池 ACE 提供了可能作为 MS 患者数字认知评估的模块。

试验注册

ClinicalTrials.gov NCT03569618;https://clinicaltrials.gov/ct2/show/NCT03569618。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d54d/8759021/8e11a854206a/jmir_v23i12e25748_fig1.jpg

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