Department of Neurology, St. Vincent's University Hospital, Dublin 4, Ireland.
School of Medicine, University College Dublin, Dublin, Ireland.
J Neuropsychol. 2023 Mar;17(1):32-62. doi: 10.1111/jnp.12285. Epub 2022 Jul 12.
Impairments in speech and social cognition have been reported in people with multiple sclerosis (pwMS), although their relationships with neuropsychological outcomes and their clinical utility in MS are unclear.
To evaluate word finding, prosody and social cognition in pwMS relative to healthy controls (HC).
We recruited people with relapsing MS (RMS, n = 21), progressive MS (PMS, n = 24) and HC (n = 25) from an outpatient MS clinic. Participants completed a battery of word-finding, social cognitive, neuropsychological and clinical assessments and performed a speech task for prosodic analysis.
Of 45 pwMS, mean (SD) age was 49.4 (9.4) years, and median (range) Expanded Disability Severity Scale score was 3.5 (1.0-6.5). Compared with HC, pwMS were older and had slower information processing speed (measured with the Symbol Digit Modalities Test, SDMT) and higher depression scores. Most speech and social cognitive measures were associated with information processing speed but not with depression. Unlike speech, social cognition consistently correlated with intelligence and memory. Visual naming test mean response time (VNT-MRT) demonstrated worse outcomes in MS versus HC (p = .034, Nagelkerke's R = 65.0%), and in PMS versus RMS (p = .009, Nagelkerke's R = 50.2%). Rapid automatised object naming demonstrated worse outcomes in MS versus HC (p = .014, Nagelkerke's R = 49.1%). These word-finding measures showed larger effect sizes than that of the SDMT (MS vs. HC, p = .010, Nagelkerke's R = 40.6%; PMS vs. RMS, p = .023, Nagelkerke's R = 43.5%). Prosody and social cognition did not differ between MS and HC.
Word finding, prosody and social cognition in MS are associated with information processing speed and largely independent of mood. Impairment in visual object meaning perception is potentially a unique MS disease-related deficit that could be further explored and cautiously considered as an adjunct disability metric for MS.
多发性硬化症（MS）患者存在言语和社会认知障碍，但这些障碍与神经心理学结果的关系及其在 MS 中的临床应用尚不清楚。
评估 MS 患者与健康对照者（HC）在词搜索、韵律和社会认知方面的差异。
我们从门诊 MS 诊所招募了复发性 MS（RMS，n=21）、进展性 MS（PMS，n=24）和 HC（n=25）患者。参与者完成了一系列词搜索、社会认知、神经心理学和临床评估，并进行了韵律分析的言语任务。
45 名 MS 患者中，平均（SD）年龄为 49.4（9.4）岁，扩展残疾严重程度评分中位数（范围）为 3.5（1.0-6.5）。与 HC 相比，MS 患者年龄较大，信息处理速度较慢（以符号数字模态测试[SDMT]测量），抑郁评分较高。大多数言语和社会认知测量结果与信息处理速度相关，但与抑郁无关。与言语不同，社会认知与智力和记忆始终相关。视命名测试平均反应时间（VNT-MRT）显示 MS 患者的结果较 HC 差（p=0.034，Nagelkerke 的 R=65.0%），PMS 患者的结果较 RMS 差（p=0.009，Nagelkerke 的 R=50.2%）。快速自动命名物体测试显示 MS 患者的结果较 HC 差（p=0.014，Nagelkerke 的 R=49.1%）。这些词搜索测量的效应量大于 SDMT（MS 与 HC，p=0.010，Nagelkerke 的 R=40.6%；PMS 与 RMS，p=0.023，Nagelkerke 的 R=43.5%）。MS 患者和 HC 之间的韵律和社会认知无差异。
MS 患者的词搜索、韵律和社会认知与信息处理速度相关，且在很大程度上与情绪无关。视觉物体意义感知障碍可能是 MS 特有的一种疾病相关缺陷，可以进一步探索，并谨慎考虑作为 MS 的附加残疾指标。
