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多发性硬化症的认知障碍:全科医生在认知筛查和护理协调中的作用。

Cognitive impairment in multiple sclerosis: The role of the general practitioner in cognitive screening and care coordination.

机构信息

BSc (Hons), MSc, MA (Clinical Neuropsychology), PhD, Fellow of the Australian Psychological Society@s College of Clinical Neuropsychologists, Clinical Neuropsychologist, Uniting War Memorial Hospital, Waverley, NSW.

BBus (HRM), BPsych (Hons), MClinNeuro, PhD, Senior Lecturer, Clinical Neuropsychologist, School of Psychological Sciences, University of Tasmania, Newnham, Tas; Launceston General Hospital, Launceston, Tas.

出版信息

Aust J Gen Pract. 2022 Apr;51(4):225-231. doi: 10.31128/AJGP-08-21-6145.

DOI:10.31128/AJGP-08-21-6145
PMID:35362006
Abstract

BACKGROUND

Cognitive impairment is common in multiple sclerosis (MS) and can have an impact on all aspects of daily life. It is also an early marker of increased MS disease activity and indicates the need to optimise disease-modifying therapies to slow progression and preserve brain functioning. However, it is difficult to detect on clinical interview alone, and patient self-report is unreliable.

OBJECTIVE

General practitioners (GP) can have a key role in the screening and initial management of cognitive impairment, but they need the right tools to do so. This aim of this article is to describe the best cognitive screening tools to use in MS and some psychological screening tools that can provide useful additional clinical information.

DISCUSSION

The various ways in which information gleaned from applying these tools can guide GPs' care plans related to the effective management and treatment of cognitive impairment during three stages in the trajectory of cognitive change in MS are discussed.

摘要

背景

认知障碍在多发性硬化症(MS)中很常见,会对日常生活的各个方面产生影响。它也是 MS 疾病活动度增加的早期标志物,表明需要优化疾病修正治疗,以减缓进展并保护大脑功能。然而,仅凭临床访谈很难发现,而且患者的自我报告不可靠。

目的

全科医生(GP)可以在认知障碍的筛查和初步管理中发挥关键作用,但他们需要正确的工具来做到这一点。本文的目的是描述用于 MS 的最佳认知筛查工具,以及一些可以提供有用附加临床信息的心理筛查工具。

讨论

讨论了从应用这些工具中收集的信息以三种方式指导 GP 护理计划的相关内容,这些方式涉及 MS 患者认知变化轨迹中的认知障碍的有效管理和治疗。

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BMC Neurol. 2024 Nov 19;24(1):454. doi: 10.1186/s12883-024-03943-2.
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Brain Behav. 2023 Jun;13(6):e3009. doi: 10.1002/brb3.3009. Epub 2023 Apr 16.