Suchá Bianka, Šiarnik Pavel, Klobucká Stanislava, Turčáni Peter, Kollár Branislav
1st Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
Rehabilitation Center Harmony n.o., Bratislava, Slovakia.
Neuro Endocrinol Lett. 2023 Jul 28;44(5):283-289.
Cognitive impairment (CI) may be present in people with multiple sclerosis (PwMS) in different stages of the disease, as well as in PwMS with various degrees of disability. This study aimed to investigate cognitive decline over a period of 12 months and to examine an association between cognition and the disability in PwMS, also over a period of 12 months.
The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was used, containing the Symbol Digit Modalities Test (SDMT), the Categorical Verbal Learning Test (CVLT), and the Brief Visuospatial Memory Test-Revised (BVMT-R). The Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9-HPT) were used to assess the degree of disability. For the analysis of cognitive decline over the period of 12 months, Wilcoxon signed-rank test (paired sample t-test) was used. For the correlation between cognition and disability, Spearman's correlation test was used.
We observed statistically meaningful difference only in one measure of cognition (CVLT), not the other two (SDMT and BVMT-R). SDMT significantly correlated with methods assessing the degree of disability in both time points. In the second examination, we observed a correlation between BICAMS and 9-HPT. Similarly, SDMT and BVMT-R also correlated with EDSS.
To investigate the cognitive decline in PwMS, a longer period of time probably should have been chosen. EDSS is commonly used to monitor disease progression, but it does not include the evaluation of various parameters, such as cognition or upper limb function. Its use with the 9-HPT and cognitive tests may represent a more reliable and comprehensive assessment of a patient's clinical condition.
认知障碍（CI）可能存在于多发性硬化症患者（PwMS）疾病的不同阶段，以及不同残疾程度的PwMS患者中。本研究旨在调查12个月期间的认知衰退情况，并研究PwMS患者认知与残疾之间在12个月期间的关联。
使用了简短国际多发性硬化症认知评估（BICAMS）套件，其中包括符号数字模式测验（SDMT）、分类言语学习测验（CVLT）和修订版简短视觉空间记忆测验（BVMT-R）。使用扩展残疾状态量表（EDSS）、25英尺计时步行试验（T25FW）和9孔插钉试验（9-HPT）来评估残疾程度。对于12个月期间认知衰退的分析，使用了Wilcoxon符号秩检验（配对样本t检验）。对于认知与残疾之间的相关性，使用了Spearman相关性检验。
我们仅在一项认知测量（CVLT）中观察到具有统计学意义的差异，而在其他两项测量（SDMT和BVMT-R）中未观察到。在两个时间点，SDMT均与评估残疾程度的方法显著相关。在第二次检查中，我们观察到BICAMS与9-HPT之间存在相关性。同样，SDMT和BVMT-R也与EDSS相关。
为了研究PwMS患者的认知衰退，可能应该选择更长的时间段。EDSS通常用于监测疾病进展，但它不包括对各种参数的评估，如认知或上肢功能。将其与9-HPT和认知测试一起使用可能代表对患者临床状况更可靠和全面的评估。
