Section of Neurology, Department of Medicine and Surgery, University of Perugia, Piazzale Severi 8, Perugia 06132, Italy..
Section of Neurology, Department of Medicine and Surgery, University of Perugia, Piazzale Severi 8, Perugia 06132, Italy.
Mult Scler Relat Disord. 2024 May;85:105548. doi: 10.1016/j.msard.2024.105548. Epub 2024 Mar 8.
Cognitive impairment (CI) is a common and disabling feature of people with multiple sclerosis (pwMS), but its underlying mechanisms are heterogenous and not fully understood. A role of infiltrating immune cells in the meninges and brain parenchyma has been hypothesized. This study aimed to explore the hypothesis that intrathecal B cells might influence cognitive performance in pwMS.
A retrospective study was performed on 39 newly diagnosed pwMS who underwent cerebrospinal fluid (CSF) analysis. Kappa (κ)-index was measured as a biomarker of intrathecal B cell activation. Cognitive performance was assessed using the Brief Repeatable Battery of Neuropsychological Tests (BRBN). Brain T2 lesions number (T2LN) and volume (T2LV) together with brain, cortical grey matter, thalamic and hippocampal volumes were calculated to account for MRI-visible damage.
κ-index was higher in pwMS with verbal memory impairment (median 99.6, range 58.5-195.2 vs. median 37.2, range 2.3-396.9, p < 0.001), and it was negatively associated with BRBN tests exploring verbal memory and information processing speed. In multivariate models, higher κ-index was confirmed to be independently associated with worse scores of BRBN tests exploring verbal memory and with a higher probability of verbal memory impairment.
Intrathecal B cells might drive memory impairment in pwMS independently of brain damage visible on MRI scans.
认知障碍（CI）是多发性硬化症（pwMS）患者常见且致残的特征，但其潜在机制尚不清楚且各不相同。人们假设脑膜和脑实质中浸润的免疫细胞可能起作用。本研究旨在探讨鞘内 B 细胞是否可能影响 pwMS 的认知表现这一假说。
对 39 名新诊断的 pwMS 患者进行了一项回顾性研究，这些患者接受了脑脊液（CSF）分析。kappa（κ）指数作为鞘内 B 细胞激活的生物标志物进行了测量。使用简短重复神经心理测试（BRBN）评估认知表现。计算 T2 病变数量（T2LN）和体积（T2LV）以及脑、皮质灰质、丘脑和海马体积，以反映 MRI 可见的损伤。
κ 指数在存在言语记忆障碍的 pwMS 中更高（中位数 99.6，范围 58.5-195.2 与中位数 37.2，范围 2.3-396.9，p < 0.001），并且与 BRBN 测试中探索言语记忆和信息处理速度的测试呈负相关。在多变量模型中，较高的 κ 指数与 BRBN 测试中探索言语记忆的得分更差以及言语记忆障碍的可能性更高独立相关。
鞘内 B 细胞可能独立于 MRI 扫描可见的脑损伤驱动 pwMS 的记忆障碍。
