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[多发性硬化症中的智力和情绪障碍]

[Intellectual and mood disorders in multiple sclerosis].

作者信息

Truelle J L, Palisson E, Le Gall D, Stip E, Derouesne C

机构信息

Service de neurologie, C.H.U., Angers.

出版信息

Rev Neurol (Paris). 1987;143(8-9):595-601.

PMID:3671962
Abstract

Reports of frequency and interpretation of intellectual and mood disorders differ in multiple sclerosis (MS). Forty-one patients with MS defined according to MacAlpine's criteria were evaluated by psychometric tests (WAIS) and neuropsychologic examinations (study of language, gnosic and praxic activities, dynamic gestural organization, memory and learning) together with, in 24 of them, the AMDP psychopathologic rating scale. Intellectual disorders were noted in 65 p. 100 of patients. Although more frequent in severe and chronic forms they were nevertheless of early onset since more than a half of the patients with onset of disease less than 5 years ago were affected. Their semiology was fairly homogeneous, combining disturbances of dynamic gestural organization (decomposition or simplification) and memory and learning deficiencies without anomalies of instrumental functions or usual psychometric mental deterioration. Application of the AMDP scale failed to reveal any psychotic type of disorders. Mood disturbances were predominant, affecting 60 p. 100 of the subpopulation studied (24 cases) and combining, in an unexpected manner: dysphoria, euphoria and depression. Only euphoria appeared to be correlated with intellectual disorders. Frequency of both intellectual and mood disorders was similar to that reported in other series published. The relative homogeneity of semiology, seen by the correlation between the different disturbances (decomposition and simplification, plateau learning curve and euphoria) and the unusual grouping of these effects, is suggestive of their organic basis. In addition, signs and symptoms resemble the neuropsychological expression of frontal lobe lesions and certain lesions of central grey nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在多发性硬化症(MS)中,关于智力和情绪障碍的发生率及解读的报告存在差异。根据麦卡尔平标准定义的41例MS患者通过心理测量测试(韦氏成人智力量表)和神经心理学检查(语言、认知和运用活动、动态手势组织、记忆和学习研究)进行评估,其中24例患者还使用了AMDP精神病理评定量表。65%的患者存在智力障碍。尽管在严重和慢性形式中更为常见,但它们仍起病较早,因为超过一半的发病不到5年的患者受到影响。其症状学相当一致,包括动态手势组织障碍(分解或简化)以及记忆和学习缺陷,而工具性功能无异常或无常见的心理测量智力衰退。应用AMDP量表未发现任何精神病类型的障碍。情绪障碍占主导,在所研究的亚组(24例)中影响了60%,且以一种意想不到的方式组合:烦躁不安、欣快和抑郁。只有欣快似乎与智力障碍相关。智力和情绪障碍的发生率与其他已发表系列报告的相似。不同障碍之间的相关性(分解和简化、学习曲线平台期和欣快)以及这些效应的异常组合所显示的症状学相对一致性提示了它们的器质性基础。此外,体征和症状类似于额叶病变和某些中央灰质核病变的神经心理学表现。(摘要截短于250字)

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