Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Mult Scler. 2023 Nov;29(13):1632-1645. doi: 10.1177/13524585231198746. Epub 2023 Sep 29.
Depression symptoms are prevalent in multiple sclerosis (MS) and associated with poorer cognition in cross-sectional studies; it is unknown whether changes in depression symptoms track with cognitive changes longitudinally.
Investigate whether changes in depression symptoms correspond with cognitive changes over time in MS, and identify specific cognitive functions related to depression symptoms.
Persons with early relapse-onset MS ( = 165) completed a depression questionnaire (Beck Depression Inventory FastScreen) and tests of cognitive speed, executive control, and memory at baseline and 3-year follow-up. One-way ANOVAs assessed differences in cognitive change across participants with worsened, stable, or improved depression symptoms from baseline to year 3.
Change in depression symptoms was related to change in executive control ( = 0.001, η = 0.08; worsened mood with worsened executive control; improved mood with improved executive control), even when adjusting for cognitive speed ( = 0.002, η = 0.08). There were no links to cognitive speed ( = 0.826) or memory ( = 0.243). Regarding individual depression symptoms, executive control was related to loss of pleasure and suicidal thoughts.
Executive control tracks with depression symptoms, raising hope that management of mood may improve executive control. The specific link between executive control and anhedonia implicates dysfunctional reward processing as a key component of MS depression.
抑郁症在多发性硬化症（MS）中很常见，与横断面研究中的认知功能较差有关；目前尚不清楚抑郁症症状的变化是否与纵向认知变化有关。
研究多发性硬化症患者中抑郁症症状的变化是否与认知随时间的变化相关，以及确定与抑郁症症状相关的特定认知功能。
165 名早期复发型多发性硬化症患者在基线和 3 年随访时完成了抑郁问卷（贝克抑郁量表快速筛查）和认知速度、执行控制和记忆测试。单因素方差分析评估了从基线到第 3 年时，抑郁症状恶化、稳定或改善的参与者的认知变化差异。
抑郁症状的变化与执行控制的变化相关（ = 0.001，η = 0.08；情绪恶化与执行控制恶化相关；情绪改善与执行控制改善相关），即使在调整认知速度后也是如此（ = 0.002，η = 0.08）。与认知速度（ = 0.826）或记忆（ = 0.243）无关。对于个体的抑郁症状，执行控制与快感缺失和自杀念头有关。
执行控制与抑郁症状相关，这增加了改善情绪可能会改善执行控制的希望。执行控制与快感缺失之间的特定联系暗示了功能失调的奖励处理是多发性硬化症抑郁的一个关键组成部分。
