Miao Yan, Zhong Xiaoling, Jia Shuangshuang, Bian Yang, Han Jinming, Qiu Feng
Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha 410008, China.
Department of Neurology, School of Medicine, South China University of Technology, Guangzhou 510006, China.
Brain Sci. 2023 Jan 2;13(1):90. doi: 10.3390/brainsci13010090.
Objective: To explore the characteristics and dynamic evolution of cognitive impairment in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: Twenty-five patients with acute NMOSD and 30 age-matched healthy individuals were consecutively recruited in this study. The Montreal Cognitive Assessment (MoCA), Chinese Version of Rey Auditory Vocabulary Learning Test (CRAVLT), Verbal Fluency Test (VFT), Digital Span Test (DST), Paced Auditory Serial Addition Task 3/2s version (PASAT-3/2), Rey−Osterrieth Complex Figure Test (ROCF) and Stroop Color and Word Test (CWT) were used to evaluate cognitive function. The correlations between cognitive function and serum aquaporin-4 (AQP-4) antibody titer were analyzed. Results: Sixty-four percent of patients with acute NMOSD had cognitive dysfunction. MoCA (p < 0.001), CRAVLT-N7 (p = 0.004), CRAVLT-N8 (p = 0.011), ROCF-C (p = 0.005), ROCF-R (p < 0.001), PASAT-3 (p = 0.013), PASAT-2 (p = 0.001) and CWT-A (p = 0.017) were significantly worse in patients with acute NMOSD than those in control group. During follow-up visits, significant differences of serum AQP-4 antibody titers were still noted in NMOSD patients (p < 0.001), while no significant differences were found by MoCA. Conclusion: A high number of patients with acute NMOSD suffer from cognitive dysfunction. Serum AQP-4 antibody titers can decrease during disease remission, while obvious cognitive decline in these patients still exists.
探讨视神经脊髓炎谱系障碍（NMOSD）患者认知障碍的特征及动态演变。方法：本研究连续纳入25例急性NMOSD患者和30例年龄匹配的健康个体。采用蒙特利尔认知评估量表（MoCA）、中文版雷伊听觉词语学习测验（CRAVLT）、言语流畅性测验（VFT）、数字广度测验（DST）、3/2秒版听觉连续加法测验（PASAT - 3/2）、雷伊 - 奥斯特里茨复杂图形测验（ROCF）和斯特鲁普颜色和词语测验（CWT）评估认知功能。分析认知功能与血清水通道蛋白4（AQP - 4）抗体滴度之间的相关性。结果：64%的急性NMOSD患者存在认知功能障碍。急性NMOSD患者的MoCA（p < 0.001）、CRAVLT - N7（p = 0.004）、CRAVLT - N8（p = 0.011）、ROCF - C（p = 0.005）、ROCF - R（p < 0.001）、PASAT - 3（p = 0.013）、PASAT - 2（p = 0.001）和CWT - A（p = 0.017）均显著差于对照组。随访期间，NMOSD患者血清AQP - 4抗体滴度仍有显著差异（p < 0.001），而MoCA未发现显著差异。结论：大量急性NMOSD患者存在认知功能障碍。疾病缓解期血清AQP - 4抗体滴度可下降，但这些患者仍存在明显的认知衰退。
